Une comparaison des journaux non structurés et des journaux structurés rédigés par les étudiants en hygiène dentaire

The Canadian Dental Hygienists Association (CDHA) has indicated that there is a need for research in education in the field of dental hygiene. It seems that when compared to the nursing profession, the profession of dental hygiene is only in the earliest stages of investigating ways of teaching critical thinking. The faculty of the dental hygiene program at John Abbott College has always valued the skill of self-assessment in the students, yet there are few specific learning activities provided whereby the students can learn how to perfect and work on this invaluable skill of self-reflection in order to better self-assess. Although self-assessment is required of the students upon the completion of each clinical experience in Clinic 1, 2 and 3, a modest amount of clinical time is allotted to reflect upon this most important skill. It appears that more could be done to prepare our students to assess their learning and clinical practice. Self-reflection as an essential element of practice has a valid place in professional education. The purpose of conducting this study was to find out whether unstructured or structured self-reflective journal writing is a sound pedagogical technique to encourage dental hygiene students’ self-assessment through self-reflection. The research design for the project was a single case study. The paradigm for the study was chosen with a purposeful selection of participants, involving twenty-seven, third-year dental hygiene students at John Abbott College. The students were arbitrarily enrolled in two sections, which for the purpose of this study were referred to as Group A and Group B. Three duplicated coded anonymous journal entries from each student were collected over a ten-week period during the Fall 2009 semester. To examine the students’ level of self-reflection, two methods were used. First a content analysis of reflective journals was used to ascertain the level and substance of the reflections from their clinical experiences with the intent of looking more specifically at the students’ self-assessment. The journal entries were coded and analyzed after the grades were submitted at the end of the school term. This was followed by the distribution of an anonymous questionnaire to the students in both sections. The responses of the questionnaire were tabulated and analyzed. An analysis was done on the data collected in order to determine whether age, education and or mother tongue of the students in both Groups A and B had an influence on their perceptions of journal writing, as well as the student’s opinions about the value of journal writing. This questionnaire included two open-ended questions to assist in gathering additional data on the student’s thoughts on writing journals. A content analysis of the qualitative data collected from the open-ended questions in the questionnaire was also analyzed. Results indicated there were very few differences in the level of self-reflection leading to self-assessment. However, students in Group B who were assigned structured journals showed more evidence of deeper learning. Taken as a whole, the journal entries clearly showed the students were involved in ‘reflection-on-action’ of their clinical experiences (Schon 1987, as cited in Asadoorian & Batty, 2005). The quality of the responses for the most part indicated the students took the time and effort to record their perceptions of their clinical experiences. It is important to note that the results do indicate that students did show a need to self-reflect and assess. The students did in fact validate the importance of reflection through journal writing, even though they did not particularly like it as an added assignment. The journals were found to be very helpful to the research in getting to know what the issues were that held the students’ attention. They explained how and to what extent the students developed relationships with their clients. It was obvious that clinicians have an impact and influence on student learning. The students value the help, role modeling, patience, encouraging words and or gestures, positive reinforcement, and understanding provided by their clinicians. This research provides some evidence that students do believe that self-reflection through structured journal writing helped them better prepare for future clinical sessions with their clients. Our goal as educators should be to encourage dental hygiene students to self-assess through written self-reflection as an established practice for deeper learning.

La perdita di chance nel prisma del danno non patrimoniale

Il danno da perdita di chance rappresenta la categoria giuridica di cui la giurisprudenza si serve per ampliare i confini della tutela risarcitoria, in diversi casi in cui, alla stregua dell’impostazione dogmatica tradizionale, non potrebbe dirsi configurabile un danno-conseguenza (né sotto forma di danno emergente, né sotto forma di lucro cessante). Lo studio, una volta delimitato il campo dell’indagine e dato conto delle opinioni dottrinali sulla ricostruzione della figura, ha preso le mosse dall’illustrazione degli orientamenti della giurisprudenza, la quale, a partire dagli anni ’80 del secolo scorso, è andata via via applicando l’istituto nei settori del diritto del lavoro, della responsabilità professionale (in particolare dell’avvocato), e del danno alla persona (nel quale ultimo si è messo in luce come il danno da perdita di chance possa rivestire funzione unicamente descrittiva di tipologie di pregiudizio riconducibili alle “tradizionali” voci di danno). Nel secondo capitolo si è analiticamente esaminata la fattispecie del danno da perdita di chance, alla luce delle categorie e dei principi generali della responsabilità civile, vagliando i margini di “armonizzabilità” dell’istituto rispetto alle classificazioni in termini di danno emergente/lucro cessante, danno presente/futuro, danno-evento/danno-conseguenza, nonché rispetto alle regole sulla causalità, al requisito dell’ingiustizia del danno, e alle tecniche di liquidazione del danno. Nell’ultimo capitolo, si è proceduto, poi, a “calare” l’istituto del danno da perdita di chance nel “sottosettore” della responsabilità sanitaria, sottoponendo a verifica la “tenuta teorica” della sua “variante” non patrimoniale al cospetto della recente novella legislativa rappresentata dalla l. n. 24/17, nonché degli orientamenti giurisprudenziali che, negli ultimi due anni, hanno interessato i temi dell’onere della prova del nesso causale e dello stesso danno da perdita di chance non patrimoniale. A conclusione dello studio, si sono svolte, infine, alcune considerazioni sulle criticità che precludono un’armonica “riconduzione a sistema” dell’istituto, consigliandone il definitivo abbandono.

Multi-Principal Agency and the Compliance with Professional Guidelines in Health Systems: Economic and Regulatory Perspectives

Amid the trend of rising health expenditure in developed economies, changing the healthcare delivery models is an important point of action for service regulators to contain this trend. Such a change is mostly induced by either financial incentives or regulatory tools issued by the regulators and targeting service providers and patients. This creates a tripartite interaction between service regulators, professionals, and patients that manifests a multi-principal agent relationship, in which professionals are agents to two principals: regulators and patients. This thesis is concerned with such a multi-principal agent relationship in healthcare and attempts to investigate the determinants of the (non-)compliance to regulatory tools in light of this tripartite relationship. In addition, the thesis provides insights into the different institutional, economic, and regulatory settings, which govern the multi-principal agent relationship in healthcare in different countries. Furthermore, the thesis provides and empirically tests a conceptual framework of the possible determinants of (non-)compliance by physicians to regulatory tools issued by the regulator. The main findings of the thesis are first, in a multi-principal agent setting, the utilization of financial incentives to align the objectives of professionals and the regulator is important but not the only solution. This finding is based on the heterogeneity in the financial incentives provided to professionals in different health markets, which does not provide a one-size-fits-all model of financial incentives to influence clinical decisions. Second, soft law tools as clinical practice guidelines (CPGs) are important tools to mitigate the problems of the multi-principal agent setting in health markets as they reduce information asymmetries while preserving the autonomy of professionals. Third, CPGs are complex and heterogeneous and so are the determinants of (non-)compliance to them. Fourth, CPGs work but under conditions. Factors such as intra-professional competition between service providers or practitioners might lead to non-compliance to CPGs – if CPGs are likely to reduce the professional’s utility. Finally, different degrees of soft law mandate have different effects on providers’ compliance. Generally, the stronger the mandate, the stronger the compliance, however, even with a strong mandate, drivers such as intra-professional competition and co-management of patients by different professionals affected the (non-)compliance.

“Fight Forever”. L’identità narrativa del professional wrestling

L'elaborato analizza l'evoluzione delle forme narrative specifiche al contesto del Pro-Wrestling statunitense, dalla nascita della sua accezione moderna nei primi anni del ventesimo secolo fino alle principali forme di Sport-Entertainment oggi conosciute in tutto il globo. Particolare attenzione è posta sulle tecniche impiegate dalla disciplina per narrare una storia, dalla struttura dei suoi eventi fino a espedienti ricorrenti nelle sue trame. Per un adeguato studio della materia in questi termini, la prospettiva impiegata punta a separare definitivamente il Wrestling professionistico dalle simili forme di narrazione seriale a cui negli anni è stato frequentemente associato, al fine ultimo di identificare un set essenziale di caratteristiche che delineino una sua esclusiva identità narrativa.

Localizzazione e internazionalizzazione dei servizi di incrocio domanda/offerta di lavoro di Jopla S.r.l SB: tra traduzione umana e traduzione automatica

This thesis has been written as a result of the Language Toolkit project, organised by the Department of Interpreting and Translation of Forlì in collaboration with the Chamber of Commerce of Romagna. The aim of the project is to facilitate the internationalisation of small and medium enterprises in Romagna by making available to them the skills acquired by the students of the Faculty of Specialized Translation, who in turn are given the opportunity to approach an authentic professional context. Specifically, this thesis is the outcome of the 300-hour internship envisaged by the project, 75 of which were carried out at Jopla S.r.l. SB. The task assigned to the student was the translation into French of the Jopla For You web app and the Jopla PRO mobile app. This thesis consists of five chapters. The first chapter provides a general description of the Language Toolkit project and it focuses on the concept of translation into a non-native language. The second chapter outlines the theoretical context in which translation is set. Subsequently, the focus shifts to the topics of text, discourse, genre and textual typology, alongside a reflection on the applicability of these notions to web texts, and an analysis of the source text following Nord's model. The fourth chapter is dedicated to a description of the resources used in the preparation and translation phases. The fifth chapter describes the macro and micro strategies employed to carry out the translation. Furthermore, a comparative analysis between the human translation and the one provided by Google Translator is delivered. This analysis involves two methods: the first one follows the linguistic norms of the target language, while the second one relies on the error categorisation of the MQM model. Finally, the performance of Google Translate is investigated through the comparison of the results obtained from the MQM evaluation conducted in this thesis with the results obtained by Martellini (2021) in her analysis.

Ma il machine interpreting sogna pecore elettroniche? Case study del dispositivo WT2 Plus in contesto reale

Il presente elaborato analizza le rese del sistema di interpretazione automatica WT2 Plus di Timekettle in un reale contesto didattico. Nello specifico, sono state condotte tre sperimentazioni presso l’Accademia Europea di Manga utilizzando due modalità di interpretazione supportate dal dispositivo. L’obiettivo è valutare la qualità di un sistema di interpretazione automatica in un contesto reale, dato che allo stato attuale mancano studi che valutino la performance di questi dispositivi nei reali contesti per i quali sono stati sviluppati. Il primo capitolo ripercorre la storia dell’interpretazione automatica, cui fa seguito la spiegazione della tecnologia alla base dei sistemi disponibili sul mercato, di cui poi si presenta lo stato dell’arte. Successivamente si delinea in breve il prossimo passaggio evolutivo nell’interpretazione automatica e si analizzano tre casi studio simili a quello proposto. Il capitolo si conclude con l’approccio scelto per valutare la performance del dispositivo. Il secondo capitolo, dedicato alla metodologia, si apre con una panoramica su WT2 Plus e sull’azienda produttrice per poi descrivere il metodo usato nelle sperimentazioni. Nello specifico, le sperimentazioni sono state condotte durante alcune delle attività previste nel normale svolgimento delle lezioni presso l’Accademia Europea di Manga con il coinvolgimento di uno studente anglofono e di due membri del personale accademico. I dati raccolti sono analizzati e discussi rispettivamente nei capitoli 3 e 4. I risultati ottenuti sembrano suggerire che il dispositivo non sia, allo stato attuale, compatibile con un reale contesto didattico, per via del quasi mancato funzionamento di una delle modalità prescelte, per il servizio di interpretazione, che risulta ancora troppo letterale, la monotonia dell’intonazione della voce automatica e infine per la traduzione quasi completamente errata della terminologia tecnica.

Egfr Activating Mutations And Their Association With Response To Platinum-doublet Chemotherapy In Brazilian Non-small Cell Lung Cancer Patients.

The aim of the study was to analyze the frequency of epidermal growth factor receptor (EGFR) mutations in Brazilian non-small cell lung cancer patients and to correlate these mutations with response to benefit of platinum-based chemotherapy in non-small cell lung cancer (NSCLC). Our cohort consisted of prospective patients with NSCLCs who received chemotherapy (platinum derivates plus paclitaxel) at the [UNICAMP], Brazil. EGFR exons 18-21 were analyzed in tumor-derived DNA. Fifty patients were included in the study (25 with adenocarcinoma). EGFR mutations were identified in 6/50 (12 %) NSCLCs and in 6/25 (24 %) adenocarcinomas; representing the frequency of EGFR mutations in a mostly self-reported White (82.0 %) southeastern Brazilian population of NSCLCs. Patients with NSCLCs harboring EGFR exon 19 deletions or the exon 21 L858R mutation were found to have a higher chance of response to platinum-paclitaxel (OR 9.67 [95 % CI 1.03-90.41], p = 0.047). We report the frequency of EGFR activating mutations in a typical southeastern Brazilian population with NSCLC, which are similar to that of other countries with Western European ethnicity. EGFR mutations seem to be predictive of a response to platinum-paclitaxel, and additional studies are needed to confirm or refute this relationship.

Fatty Acid Synthase Inhibitors Induce Apoptosis In Non-tumorigenic Melan-a Cells Associated With Inhibition Of Mitochondrial Respiration.

The metabolic enzyme fatty acid synthase (FASN) is responsible for the endogenous synthesis of palmitate, a saturated long-chain fatty acid. In contrast to most normal tissues, a variety of human cancers overexpress FASN. One such cancer is cutaneous melanoma, in which the level of FASN expression is associated with tumor invasion and poor prognosis. We previously reported that two FASN inhibitors, cerulenin and orlistat, induce apoptosis in B16-F10 mouse melanoma cells via the intrinsic apoptosis pathway. Here, we investigated the effects of these inhibitors on non-tumorigenic melan-a cells. Cerulenin and orlistat treatments were found to induce apoptosis and decrease cell proliferation, in addition to inducing the release of mitochondrial cytochrome c and activating caspases-9 and -3. Transfection with FASN siRNA did not result in apoptosis. Mass spectrometry analysis demonstrated that treatment with the FASN inhibitors did not alter either the mitochondrial free fatty acid content or composition. This result suggests that cerulenin- and orlistat-induced apoptosis events are independent of FASN inhibition. Analysis of the energy-linked functions of melan-a mitochondria demonstrated the inhibition of respiration, followed by a significant decrease in mitochondrial membrane potential (ΔΨm) and the stimulation of superoxide anion generation. The inhibition of NADH-linked substrate oxidation was approximately 40% and 61% for cerulenin and orlistat treatments, respectively, and the inhibition of succinate oxidation was approximately 46% and 52%, respectively. In contrast, no significant inhibition occurred when respiration was supported by the complex IV substrate N,N,N',N'-tetramethyl-p-phenylenediamine (TMPD). The protection conferred by the free radical scavenger N-acetyl-cysteine indicates that the FASN inhibitors induced apoptosis through an oxidative stress-associated mechanism. In combination, the present results demonstrate that cerulenin and orlistat induce apoptosis in non-tumorigenic cells via mitochondrial dysfunction, independent of FASN inhibition.

Imported Malaria In A Non-endemic Area: The Experience Of The University Of Campinas Hospital In The Brazilian Southeast.

Although malaria in Brazil almost exclusively occurs within the boundaries of the Amazon Region, some concerns are raised regarding imported malaria to non-endemic areas of the country, notably increased incidence of complications due to delayed diagnoses. However, although imported malaria in Brazil represents a major health problem, only a few studies have addressed this subject. A retrospective case series is presented in which 263 medical charts were analysed to investigate the clinical and epidemiological characterization of malaria cases that were diagnosed and treated at Hospital & Clinics, State University of Campinas between 1998 and 2011. Amongst all medical charts analysed, 224 patients had a parasitological confirmed diagnosis of malaria. Plasmodium vivax and Plasmodium falciparum were responsible for 67% and 30% of the infections, respectively. The majority of patients were male (83%) of a productive age (median, 37 years old). Importantly, severe complications did not differ significantly between P. vivax (14 cases, 9%) and P. falciparum (7 cases, 10%) infections. Severe malaria cases were frequent among imported cases in Brazil outside of the Amazon area. The findings reinforce the idea that P. vivax infections in Brazil are not benign, regardless the endemicity of the area studied. Moreover, as the hospital is located in a privileged site, it could be used for future studies of malaria relapses and primaquine resistance mechanisms. Finally, based on the volume of cases treated and the secondary complications, referral malaria services are needed in the non-endemic areas of Brazil for a rapid and efficient and treatment.

Evaluation Of Fe Uptake And Translocation In Transgenic And Non-transgenic Soybean Plants Using Enriched Stable (57)fe As A Tracer.

A tracer experiment is carried out with transgenic T (variety M 7211 RR) and non-transgenic NT (variety MSOY 8200) soybean plants to evaluate if genetic modification can influence the uptake and translocation of Fe. A chelate of EDTA with enriched stable (57)Fe is applied to the plants cultivated in vermiculite plus substrate and the (57)Fe acts as a tracer. The exposure of plants to enriched (57)Fe causes the dilution of the natural previously existing Fe in the plant compartments and then the changed Fe isotopic ratio ((57)Fe/(56)Fe) is measured using a quadrupole-based inductively coupled plasma mass spectrometer equipped with a dynamic reaction cell (DRC). Mathematical calculations based on the isotope dilution methodology allow distinguishing the natural abundance Fe from the enriched Fe (incorporated during the experiment). The NT soybean plants acquire higher amounts of Fe from natural abundance (originally present in the soil) and from enriched Fe (coming from the (57)Fe-EDTA during the experiment) than T soybean ones, demonstrating that the NT soybean plants probably absorb higher amounts of Fe, independently of the source. The percentage of newly incorporated Fe (coming from the treatment) was approximately 2.0 and 1.1% for NT and T soybean plants, respectively. A higher fraction (90.1%) of enriched Fe is translocated to upper parts, and a slightly lower fraction (3.8%) is accumulated in the stems by NT plants than by T ones (85.1%; 5.1%). Moreover, in both plants, the Fe-EDTA facilitates the transport and translocation of Fe to the leaves. The genetic modification is probably responsible for differences observed between T and NT soybean plants.

[factors Associated With Satisfaction With Life Among Elderly Caregivers And Non-caregivers].

This article seeks to investigate associations between satisfaction with life and sociodemographic variables, health conditions, functionality, social involvement and social support among elderly caregivers and non-caregivers, as well as between satisfaction and the intensity of stress in the caregiver group. A sample of 338 caregivers was selected according to two items of the Brazilian version of the Elders Life Stress Inventory. A comparison-group of elderly non-caregivers was selected at random, with a similar gender, age and income profile. Data were derived from self-reported questionnaires and scales. Elderly caregivers with low levels of satisfaction and high levels of stress revealed more symptoms of insomnia, fatigue, diseases and worse IADL performance. Those with greater satisfaction and less stress revealed a good level of social support. Insomnia, depression and fatigue were associated with low satisfaction among caregivers, and with fatigue, depression and low social support among non-caregivers. It was considered relevant that instrumental, psychological and informative support can improve the quality of life and the quality of care provided by elderly caregivers, especially if they are affected by unfavorable health and psychosocial conditions and low satisfaction with life.

Oxidative Stress And Susceptibility To Mitochondrial Permeability Transition Precedes The Onset Of Diabetes In Autoimmune Non-obese Diabetic Mice.

Beta cell destruction in type 1 diabetes (TID) is associated with cellular oxidative stress and mitochondrial pathway of cell death. The aim of this study was to determine whether oxidative stress and mitochondrial dysfunction are present in T1D model (non-obese diabetic mouse, NOD) and if they are related to the stages of disease development. NOD mice were studied at three stages: non-diabetic, pre-diabetic, and diabetic and compared with age-matched Balb/c mice. Mitochondria respiration rates measured at phosphorylating and resting states in liver and soleus biopsies and in isolated liver mitochondria were similar in NOD and Balb/c mice at the three disease stages. However, NOD liver mitochondria were more susceptible to calcium-induced mitochondrial permeability transition as determined by cyclosporine-A-sensitive swelling and by decreased calcium retention capacity in all three stages of diabetes development. Mitochondria H2O2 production rate was higher in non-diabetic, but unaltered in pre-diabetic and diabetic NOD mice. The global cell reactive oxygen species (ROS), but not specific mitochondria ROS production, was significantly increased in NOD lymphomononuclear and stem cells in all disease stages. In addition, marked elevated rates of 2',7'-dichlorodihydrofluorescein (H2DCF) oxidation were observed in pancreatic islets from non-diabetic NOD mice. Using matrix-assisted laser desorption/ionization (MALDI) mass spectrometry (MS) and lipidomic approach, we identified oxidized lipid markers in NOD liver mitochondria for each disease stage, most of them being derivatives of diacylglycerols and phospholipids. These results suggest that the cellular oxidative stress precedes the establishment of diabetes and may be the cause of mitochondrial dysfunction that is involved in beta cell death.

Development And Characterization Of A Cationic Lipid Nanocarrier As Non-viral Vector For Gene Therapy.

The aim of the present work was to produce a cationic solid lipid nanoparticle (SLN) as non-viral vector for protein delivery. Cationic SLN were produced by double emulsion method, composed of softisan(®) 100, cetyltrimethylammonium bromide (CTAB), Tween(®) 80, Span(®) 80, glycerol and lipoid(®) S75 loading insulin as model protein. The formulation was characterized in terms of mean hydrodynamic diameter (z-ave), polydispersity index (PI), zeta potential (ZP), stability during storage time, stability after lyophilization, effect of toxicity and transfection ability in HeLa cells, in vitro release profile and morphology. SLN were stable for 30days and showed minimal changes in their physicochemical properties after lyophilization. The particles exhibited a relatively slow release, spherical morphology and were able to transfect HeLa cells, but toxicity remained an obstacle. Results suggest that SLN are nevertheless promising for delivery of proteins or nucleic acids for gene therapy.

Water Stress Reveals Differential Antioxidant Responses Of Tolerant And Non-tolerant Sugarcane Genotypes.

The biochemical responses of the enzymatic antioxidant system of a drought-tolerant cultivar (IACSP 94-2094) and a commercial cultivar in Brazil (IACSP 95-5000) grown under two levels of soil water restriction (70% and 30% Soil Available Water Content) were investigated. IACSP 94-2094 exhibited one additional active superoxide dismutase (Cu/Zn-SOD VI) isoenzyme in comparison to IACSP 95-5000, possibly contributing to the heightened response of IACSP 94-2094 to the induced stress. The total glutathione reductase (GR) activity increased substantially in IACSP 94-2094 under conditions of severe water stress; however, the appearance of a new GR isoenzyme and the disappearance of another isoenzyme were found not to be related to the stress response because the cultivars from both treatment groups (control and water restrictions) exhibited identical changes. Catalase (CAT) activity seems to have a more direct role in H2O2 detoxification under water stress condition and the shift in isoenzymes in the tolerant cultivar might have contributed to this response, which may be dependent upon the location where the excessive H2O2 is being produced under stress. The improved performance of IACSP 94-2094 under drought stress was associated with a more efficient antioxidant system response, particularly under conditions of mild stress.

Direct And Non-destructive Proof Of Authenticity For The 2nd Generation Of Brazilian Real Banknotes Via Easy Ambient Sonic Spray Ionization Mass Spectrometry.

Using a desorption/ionization technique, easy ambient sonic-spray ionization coupled to mass spectrometry (EASI-MS), documents related to the 2nd generation of Brazilian Real currency (R$) were screened in the positive ion mode for authenticity based on chemical profiles obtained directly from the banknote surface. Characteristic profiles were observed for authentic, seized suspect counterfeit and counterfeited homemade banknotes from inkjet and laserjet printers. The chemicals in the authentic banknotes' surface were detected via a few minor sets of ions, namely from the plasticizers bis(2-ethylhexyl)phthalate (DEHP) and dibutyl phthalate (DBP), most likely related to the official offset printing process, and other common quaternary ammonium cations, presenting a similar chemical profile to 1st-generation R$. The seized suspect counterfeit banknotes, however, displayed abundant diagnostic ions in the m/z 400-800 range due to the presence of oligomers. High-accuracy FT-ICR MS analysis enabled molecular formula assignment for each ion. The ions were separated by 44 m/z, which enabled their characterization as Surfynol® 4XX (S4XX, XX=40, 65, and 85), wherein increasing XX values indicate increasing amounts of ethoxylation on a backbone of 2,4,7,9-tetramethyl-5-decyne-4,7-diol (Surfynol® 104). Sodiated triethylene glycol monobutyl ether (TBG) of m/z 229 (C10H22O4Na) was also identified in the seized counterfeit banknotes via EASI(+) FT-ICR MS. Surfynol® and TBG are constituents of inks used for inkjet printing.