Frequency of Toxocara infection in children attended by the health public service of Maringá, south Brazil.

The lack of specific laboratorial diagnosis methods and precise symptoms makes the toxocariasis a neglected disease in Public Health Services. This study aims to determine the frequency of Toxocara spp. infection in children attended by the Health Public Service of Hospital Municipal de Maringá, South Brazil. To evaluate the association of epidemiological and clinical data, and observational and cross-section study was carried out. From 14,690 attended children/year aged from seven month to 12 years old, 450 serum samples were randomly collected from September/2004 to September/2005. A questionnaire was used to evaluate epidemiological, clinical and hematological data. An ELISA using Toxocara canis larval excretory-secretory products as antigen detected 130 (28.8%) positive sera, mainly between children from seven month to five years old (p = 0.0016). Significant correlation was observed between positive serology for Toxocara, and frequent playing in sandbox at school or daycare center (p = 0.011) and the presence of a cat at home (p = 0.056). From the families, 50% were dog owners which exposed soil backyards. Eosinophilia (p = 0.776), and signs and symptoms analyzed (fever p = 0.992, pneumonia p = 0.289, cold-like symptoms p = 0.277, cough p =0.783, gastrointestinal problems p = 0.877, migraine p = 0.979, abdominal pain p = 0.965, joint pain p = 0.686 and skin rash p = 0.105) could not be related to the presence of anti-Toxocara antibodies. Therefore, two asthmatics children showed titles of1:10,240 and accentuated eosinophilia (p = 0.0001). The authors emphasize the needs of prevention activities.

¿Cuán gramaticalmente complejos son los títulos de los artículos científicos en las ciencias naturales?

[EN]This paper examines a corpus of 150 titles of research articles published between 2010 and 2013 in Anglo-American natural sciences journals (physics, chemistry and biology) in order to determine their lexical density and grammatical and morphosyntactic features. Towards that end, the frequency of present and past participles, prepositions, coordinating and subordinate conjunctions, and the frequency and length of compound words was recorded in each title. The total number of content and function words was also recorded so as to determine title lexical density. ANOVA tests were applied in order to assess whether statistically significant differences in the frequency of the above mentioned variables were detected within and across disciplines and in the whole corpus.

Traces de terre, traces d'encre... La rappresentazione dello spazio nella letteratura caraibica. (Francofona e Anglofona)

This study concerns the representation of space in Caribbean literature, both francophone and Anglophone and, in particular, but not only, in the martinican literature, in the works of the authors born in the island. The analysis focus on the second half of the last century, a period in which the martinican production of novels and romances increased considerably, and where the representation and the rule of space had a relevant place. So, the thesis explores the literary modalities of this representation. The work is constituted of 5 chapters and the critical and methodological approaches are both of an analytical and comparative type. The first chapter “The caribbean space: geography, history and society” presents the geographic context, through an analysis of the historical and political major events occurred in the Caribbean archipelago, in particular of the French Antilles, from the first colonization until the départementalisation. The first paragraph “The colonized space: historical-political excursus” the explores the history of the European colonization that marked forever the theatre of the relationship between Europe, Africa and the New World. This social situation take a long and complex process of “Re-appropriation and renegotiation of the space”, (second paragraph) always the space of the Other, that interest both the Antillean society and the writers’ universe. So, a series of questions take place in the third paragraph “Landscape and identity”: what is the function of space in the process of identity construction? What are the literary forms and representations of space in the Caribbean context? Could the writing be a tool of cultural identity definition, both individual and collective? The second chapter “The literary representation of the Antillean space” is a methodological analysis of the notions of literary space and descriptive gender. The first paragraph “The literary space of and in the novel” is an excursus of the theory of such critics like Blanchot, Bachelard, Genette and Greimas, and in particular the recent innovation of the 20th century; the second one “Space of the Antilles, space of the writing” is an attempt to apply this theory to the Antillean literary space. Finally the last paragraph “Signs on the page: the symbolic places of the antillean novel landscape” presents an inventory of the most recurrent antillean places (mornes, ravines, traces, cachots, En-ville,…), symbols of the history and the past, described in literary works, but according to new modalities of representation. The third chapter, the core of the thesis, “Re-drawing the map of the French Antilles” focused the study of space representation on francophone literature, in particular on a selected works of four martinican writers, like Roland Brival, Édouard Glissant, Patrick Chamoiseau and Raphaël Confiant. Through this section, a spatial evolution comes out step by step, from the first to the second paragraph, whose titles are linked together “The novel space evolution: from the forest of the morne… to the jungle of the ville”. The virgin and uncontaminated space of the Antilles, prior to the colonisation, where the Indios lived in harmony with the nature, find a representation in both works of Brival (Le sang du roucou, Le dernier des Aloukous) and of Glissant (Le Quatrième siècle, Ormerod). The arrival of the European colonizer brings a violent and sudden metamorphosis of the originary space and landscape, together with the traditions and culture of the Caraïbes population. These radical changes are visible in the works of Chamoiseau (Chronique des sept misères, Texaco, L’esclave vieil homme et le molosse, Livret des villes du deuxième monde, Un dimanche au cachot) and Confiant (Le Nègre et l’Amiral, Eau de Café, Ravines du devant-jour, Nègre marron) that explore the urban space of the creole En-ville. The fourth chapter represents the “2nd step: the Anglophone novel space” in the exploration of literary representation of space, through an analytical study of the works of three Anglophone writers, the 19th century Lafcadio Hearn (A Midsummer Trip To the West Indies, Two Years in the French West Indies, Youma) and the contemporary authors Derek Walcott (Omeros, Map of the New World, What the Twilight says) and Edward Kamau Brathwaite (The Arrivants: A New World Trilogy). The Anglophone voice of the Caribbean archipelago brings a very interesting contribution to the critical idea of a spatial evolution in the literary representation of space, started with francophone production: “The spatial evolution goes on: from the Martiniques Sketches of Hearn… to the modern bards of Caribbean archipelago” is the new linked title of the two paragraphs. The fifth chapter “Extended look, space shared: the Caribbean archipelago” is a comparative analysis of the results achieved in the prior sections, through a dialogue between all the texts in the first paragraph “Francophone and Anglophone representation of space compared: differences and analogies”. The last paragraph instead is an attempt of re-negotiate the conventional notions of space and place, from a geographical and physical meaning, to the new concept of “commonplace”, not synonym of prejudice, but “common place” of sharing and dialogue. The question sets in the last paragraph “The “commonplaces” of the physical and mental map of the Caribbean archipelago: toward a non-place?” contains the critical idea of the entire thesis.

The influence of career histories on team perfomance in new product development: a study of the video game industry

The purpose of this research is to contribute to the literature on organizational demography and new product development by investigating how diverse individual career histories impact team performance. Moreover we highlighted the importance of considering also the institutional context and the specific labour market arrangements in which a team is embedded, in order to interpret correctly the effect of career-related diversity measures on performance. The empirical setting of the study is the videogame industry, and the teams in charge of the development of new game titles. Video games development teams are the ideal setting to investigate the influence of career histories on team performance, since the development of videogames is performed by multidisciplinary teams composed by specialists with a wide variety of technical and artistic backgrounds, who execute a significant amounts of creative thinking. We investigate our research question both with quantitative methods and with a case study on the Japanese videogame industry: one of the most innovative in this sector. Our results show how career histories in terms of occupational diversity, prior functional diversity and prior product diversity, usually have a positive influence on team performance. However, when the moderating effect of the institutional setting is taken in to account, career diversity has different or even opposite effect on team performance, according to the specific national context in which a team operates.

Johann Schöffer, Buchdrucker zu Mainz

Die Arbeit beschriebt das Leben und Wirken Johann Schöffers, des Erben der Mainzer Druckerei Johannes Fusts und Peter Schöffer d.Ä. Im Mittelpunkt stehen die 315 heute noch nachweisbaren Drucke. Neben der bibliographischen Erfassung der Titel, die ergänzt werden durch Hinweise zur Illustration und zur Typographie, wird versucht anhand dieser die Entwicklung und die Veränderungen in der Werkstatt aufzuzeigen. Von Interesse ist dabei, dass sich die historischen Ereignisse und religiösen Strömungen teilweise parallel, teilweise zeitlich versetzt im Verlagsprogramm widerspiegeln.

Der irische Buchmarkt

Der irische Buchmarkt als Teil des englischsprachigen Buchmarktes ist stark von der Geschichte des Landes geprägt. Die Fremdbestimmung im Rahmen des Commonwealth unterdrückte eine eigenständige Verlagslandschaft bis weit ins 20. Jahrhundert hinein. Mit der Unabhängigkeit des irischen Staates stieg die Anzahl der Verlage langsam aber stetig an. In den 70er Jahren kam die irische Verlagslandschaft zu einem fast explosionsartigen Erblühen. Die Gründung des Verlegerverbandes Clé war einer von vielen Schritten, um den nationalen Buchmarkt von der Dominanz britischer Bücher in Buchhandlungen und Bibliotheken zu emanzipieren. Die Nachfrage nach Irish-Interest-Titeln ist im Inland hoch. Britische Verlage hatten bis dato diesen Bedarf übersehen, und so füllten irische Verlage diese Nische. Die Einführung eines von Großbritannien unabhängigen Lehrplans führte zur Etablierung eines eigenständigen Schulbuchmarktes, inklusive Lehrwerke zur irischen Sprache bzw. Titel auf Irisch. Irische Verlage sind in ihrem Programm größtenteils breit aufgestellt und selten spezialisiert. Sie sind erstaunlich häufig unabhängige mittelständische Unternehmen. Nur wenige Verlage sind staatlich geführt oder gehören ausländischen Konzernen an. Auch der stationäre Buchhandel ist überwiegend eigenständig, da die – vor dem Wirtschaftsboom wenig kaufkräftige - Republik von den expandierenden britischen Buchhandelsketten vernachlässigt wurde. Erst nach dem Wirtschaftsboom und dem damit verbundenen soziokulturellen Wandel von einer traditionellen Agrar- hin zu einer modernen Informationsgesellschaft stiegen die Umsätze mit Büchern stark an. Sobald der Buchmarkt eine nennenswerte wirtschaftliche Größe erreichte, eröffneten britische Buchhandlungen Filialen in irischen Städten. Sie vermochten jedoch nicht, die Sortimentsvielfalt der irischen Buchhandelslandschaft zu zerstören. Die fehlende Buchpreisbindung ist keine Bedrohung der Titelvielfalt, da Handelsformen wie Buchclubs, Supermärkte und Internethandel – die mit teils aggressivem Preismarketing arbeitenden Nebenmärkte – hier nur eine Randexistenz führen. In diesem Fall wandelt sich die geringe (Umsatz-) Größe und damit Attraktivität des Buchmarktes zum Vorteil. Die staatliche Kulturförderung ist ein bedeutender Beitrag zum Verlegen von Literatur, die wirtschaftlich gerechnet keine Daseinsberechtigung hätte. Irische Verleger mit relativ geringem Budget sind nicht in der Lage, solche unökonomischen Titel mit dem finanziellen Erfolg eines Bestsellers in Mischkalkulation aufzufangen. Hier greift die staatliche Unterstützung. Die Subventionierung von Titeln über die irischen Sprache bzw. von Literatur auf Irisch führte zur Herausbildung eines Marktsektors, der vor der Staatsgründung nicht existierte. Die Übersetzungsförderung verstärkt die Verbreitung von bis dato unbekannter irischer Literatur im Ausland und stimuliert das Lizenzgeschäft. Die aktuelle staatliche Kulturpolitik setzt ihren Schwerpunkt auf Marketing, PR sowie Nachfolgeregelung und fördert so nachhaltig statt bloß in Form einer kurzlebigen Titelsubvention. Eine noch mehr in die Zukunft gerichtete Förderung würde genauso wie die Unterstützung von Fortbildungsmaßnahmen zu besseren wirtschaftlichen Rahmenbedingungen führen. Auch wenn die nationale Verlagsszene im Aufschwung begriffen ist, befindet sich der irische Buchmarkt insgesamt in fester Hand der britischen Verlagsproduktion. Der britische Buchmarkt mit seinen multinationalen und finanzkräftigen Verlagen lebt vom Export. Aus Sicht von Großbritannien ist heutzutage der Nachbar Irland, einst Teil des britischen Buchmarktes, einer der besten Kunden. Dieser Aspekt bezieht sich nicht nur auf die langjährig entwickelten Handelsbeziehungen. In kulturellen Aspekten orientiert sich Irland stark am britischen Vorbild: Ein britischer Bestseller wird fast immer auch ein Bestseller in Irland. Lediglich Irish-Interest-Titel durchbrechen diesen Automatismus. Während Irish Interest im Inland hohe Umsätze vorweist, sind diese Titel im Ausland lediglich ein Nischenprodukt. Zusätzlich müssen irische Verlage außerhalb des Landes mit britischen und US-amerikanischen Verlagen in Konkurrenz treten, die ebenfalls Irish-Interest-Titel für die irische Diaspora anbieten. Es besteht daher nur eine geringe Chance, erfolgreich am globalen englischsprachigen Buchmarkt mitzuwirken. Bis dato haben Versuche, dem irischen Buchmarkt durch Export zu Umsatzwachstum zu verhelfen, keinen nennenswerten Erfolg gebracht. Lediglich auf dem Gebiet der populären Literatur und in Form von Kooperationen mit britischen Verlagskonzernen vermögen irische Verlage, am internationalen Buchhandel teilzuhaben.

Interventi normativi, interni ed uniformi, dettati dalle nuove esigenze e dai nuovi quesiti posti dalla modernizzazione dei traffici, con particolare riferimento al trasporto containerizzato e multimodale

Come si evince dal titolo della tesi, la ricerca effettuata dal presente candidato nel corso del dottorato di ricerca ha avuto ad oggetto lo studio della materia relativa ai trasporti nell’ambito di diversi sistemi giuridici europei, con particolare attenzione ai risvolti di carattere pratico che l’interpretazione delle normative uniformi poteva produrre nell’ambito delle diverse giurisdizioni nonché alle diverse impostazioni e alla variegata gamma di soluzioni interpretative che nell’ambito di problemi simili possono essere adottate a seconda che una stessa questione venga discussa in un ordinamento piuttosto che in un altro. Dall’avvento del trasporto marittimo di containers alla necessità di disciplinare l’intera materia attraverso una normativa multimodale il passo è estremamente breve, posto che, proprio in considerazione delle caratteristiche proprie del trasporto containerizzato, gli aventi diritto al carico sono principalmente interessati al completamente del trasferimento door-to-door inteso nella sua globalità, piuttosto che al buon esito del trasporto sulla singola tratta marittima. Il progetto di revisione delle Regole dell’Aja-Visby adottato dall’United Nations Commission on International Trade Law (Uncitral) e il Comité Maritime International (CMI) costituisce per definizione un progetto limitato ad un trasporto multimodale comprendente necessariamente una tratta marittima, ma rappresenta comunque un interessante banco di prova per valutare la funzionalità di strumenti di recente impiego, come ad esempio i cosiddetti e-documents, concetto peraltro già inserito nel progetto UNCITRAL, anche se con scarsi elementi di reale novità rispetto alla tradizionale disciplina relativa ai documenti cartacei. Proprio la parte relativa ai documenti e titoli di viaggio merita particolare attenzione soprattutto in riferimento alle problematiche connesse al traffico containerizzato, con particolare riferimento al concetto di transhipment, e alla conseguente necessità che la polizza garantisca al legittimo portatore una copertura completa sull’intero viaggio della merce, oltre a dargli la possibilità di individuare agevolmente la propria controparte contrattuale, e cioè il vettore.

Strategie alimentari atte a incrementare il contenuto di Omega3 e CLA del latte

Tra i componenti naturali biologicamente attivi, e con cui è possibile arricchire il latte, notevole importanza rivestono gli acidi grassi Omega3 e i CLA. I ruoli benefici svolti da questi particolari lipidi si manifestano soprattutto nella regolazione dei processi infiammatori, nella prevenzione del diabete e delle malattie cardiovascolari; è inoltre dimostrato come i CLA abbiano attività anticancerogena e ipocolesterolemica, stimolino il sistema immunitario e prevengano l’insorgenza del diabete e delle malattie croniche non trasmissibili. Lo scopo di questo lavoro è stato quello di individuare, in condizioni sperimentali controllate e nelle comuni realtà di allevamento, le possibili strategie alimentari atte ad aumentare le concentrazioni di Omega-3 e CLA del latte vaccino, senza penalizzare i titoli di grasso del latte. I lavori sperimentali effettuati possono essere distinti in 3 fasi: una prima fase in cui l’oggetto principale delle ricerche svolte è stato l’incremento in acidi grassi Omega3 del latte, una seconda fase in cui l’obiettivo si è allargato anche all’incremento delle concentrazioni in CLA, e una terza fase che ha avuto come scopo quello di incrementare i livelli di Omega3 e CLA del latte senza penalizzare i titoli di grasso. Le strategie alimentari più efficaci si sono basate sulla modificazione degli apporti lipidici della razione attraverso la supplementazione con seme di soia o relativo olio, semi di lino o relativo olio, olii di pesce e acido stearico. Le ricerche svolte hanno evidenziato come, attraverso opportune ed accurate modulazioni degli apporti lipidici delle razioni, sia di fatto possibile innalzare i contenuti di acidi grassi della serie Omega3 e CLA nel latte vaccino, senza penalizzare i titoli del grasso del latte.

Editorial reorganization of an alphabetically ordered collection of short stories: analysis of problems and hypothesis of possible solutions

This paper aims to show, analyze and solve the problems related to the translation of the book with meaning-bond alphabetically ordered chapter titles La vita non è in ordine alfabetico, by the Italian writer Andrea Bajani. The procedure is inevitable for a possible translation of the book, and it is necessary to have a preliminary pattern to follow. After translating the whole book, not only is a revision fundamental, but a restructure and reorganization of the collection may be required, hence, what this thesis offers is a scheme to start from, together with an analysis of the possible problems that may arise, and a useful method to find a solution.

La registrazione immobiliare nell'ordinamento cinese e nelle esperienze giuridiche europee: modelli per una nuova riforma in Cina

L’ordinamento giuridico cinese contemporaneo si è, recentemente, impegnato in una riforma che ha interessato le norme vigenti in materia di registrazione immobiliare con l’intento di realizzare un sistema unitario dell’istituto. Dal momento che la modernizzazione del diritto civile cinese è iniziata - a partire dalla fine del XIX secolo – tramite il recepimento del diritto civile occidentale, la disamina delle esperienze europee in materia di pubblicità immobiliare assume una notevole importanza, al fine di esaminare le norme vigenti in Cina e i cambiamenti scaturenti dalla riforma. Pertanto, l’obiettivo della mia ricerca è stato quello di avanzare una tesi che possa rivelarsi quale strumento utile per la riforma in Cina, attraverso uno studio comparato dei modelli europei in materia di registrazione immobiliare. A tal fine, il lavoro è stato suddiviso in due parti: nella prima si è presentata un’analisi dettagliata del diritto di proprietà, del dualismo delle proprietà fondiarie e relative problematiche, del sistema dei diritti reali costituito dalla Legge sui diritti reali del 2007, da cui è partita la riforma dell’istituto della registrazione immobiliare. Un approfondimento particolare è dedicato al pluralismo dei regimi di registrazione immobiliare vigenti nel diritto cinese contemporaneo e all’introduzione dei cambiamenti apportati dal nuovo regolamento del 2015. Nella seconda parte dell’elaborato, attraverso lo studio comparato dei diversi modelli Europei (Francese, Tedesco e Inglese), si è tentato di illustrare le esperienze europee in materia di pubblicità immobiliare maturate nei tre temi maggiormente rappresentativi e concreti, quali la tutela degli interessi privatistici, l’autenticità dei titoli e il ruolo del notaio, la procedura della pubblicità immobiliare, al fine di individuare una via percorribile per il perfezionamento del sistema unitario della registrazione nell’ordinamento cinese. Nelle conclusioni, infine, sono state inserite anche alcune riflessioni circa l’importanza dello studio del diritto comparato per l’esperienza Cinese.

Neuronal Correlates of Perception, Imagery, and Memory for Familiar Tunes

We used fMRI to investigate the neuronal correlates of encoding and recognizing heard and imagined melodies. Ten participants were shown lyrics of familiar verbal tunes; they either heard the tune along with the lyrics, or they had to imagine it. In a subsequent surprise recognition test, they had to identify the titles of tunes that they had heard or imagined earlier. The functional data showed substantial overlap during melody perception and imagery, including secondary auditory areas. During imagery compared with perception, an extended network including pFC, SMA, intraparietal sulcus, and cerebellum showed increased activity, in line with the increased processing demands of imagery. Functional connectivity of anterior right temporal cortex with frontal areas was increased during imagery compared with perception, indicating that these areas form an imagery-related network. Activity in right superior temporal gyrus and pFC was correlated with the subjective rating of imagery vividness. Similar to the encoding phase, the recognition task recruited overlapping areas, including inferior frontal cortex associated with memory retrieval, as well as left middle temporal gyrus. The results present new evidence for the cortical network underlying goal-directed auditory imagery, with a prominent role of the right pFC both for the subjective impression of imagery vividness and for on-line mental monitoring of imagery-related activity in auditory areas.

A Systematic Review of the Clinical Performance of Tooth-Retained and Implant-Retained Double Crown Prostheses with a Follow-Up of ≥3 Years

Purpose: The objective of this review was to systematically screen the literature for data related to the survival and complication rates observed with dental or implant double crown abutments and removable prostheses under functional loading for at least 3 years. Materials and Methods: A systematic review of the dental literature from January 1966 to December 2009 was performed in electronic databases (PubMed and Embase) as well as by an extensive hand search to investigate the clinical outcomes of double crown reconstructions. Results: From the total of 2412 titles retrieved from the search, 65 were selected for full-text review. Subsequently, 17 papers were included for data extraction. An estimation of the cumulative survival and complication rates was not feasible due to the lack of detailed information. Tooth survival rates for telescopic abutment teeth ranged from 82.5% to 96.5% after an observation period of 3.4 to 6 years, and for tooth-supported double crown retained dentures from 66.7% to 98.6% after an observation period of 6 to 10 years. The survival rates of implants were between 97.9% and 100% and for telescopic-retained removable dental prostheses with two mandibular implants, 100% after 3.0 and 10.4 years. The major biological complications affecting the tooth abutments were gingival inflammation, periodontal disease, and caries. The most frequent technical complications were loss of cementation and loss of facings. Conclusions: The main findings of this review are: (I) double crown tooth abutments and dentures demonstrated a wide range of survival rates. (II) Implant-supported mandibular overdentures demonstrated a favorable long-term prognosis. (III) A greater need for prosthetic maintenance is required for both tooth-supported and implant-supported reconstructions. (IV) Future areas of research would involve designing appropriate longitudinal studies for comparisons of survival and complication rates of different reconstruction designs.

Visualization Techniques For The Analysis Of Network Simulation Results

The Simulation Automation Framework for Experiments (SAFE) streamlines the de- sign and execution of experiments with the ns-3 network simulator. SAFE ensures that best practices are followed throughout the workflow a network simulation study, guaranteeing that results are both credible and reproducible by third parties. Data analysis is a crucial part of this workflow, where mistakes are often made. Even when appearing in highly regarded venues, scientific graphics in numerous network simulation publications fail to include graphic titles, units, legends, and confidence intervals. After studying the literature in network simulation methodology and in- formation graphics visualization, I developed a visualization component for SAFE to help users avoid these errors in their scientific workflow. The functionality of this new component includes support for interactive visualization through a web-based interface and for the generation of high-quality, static plots that can be included in publications. The overarching goal of my contribution is to help users create graphics that follow best practices in visualization and thereby succeed in conveying the right information about simulation results.

Complementary and alternative medicine costs - a systematic literature review

Objective: The aim of this literature review, performed within the framework of the Swiss governmental Program of Evaluation of Complementary Medicine (PEK), was to investigate costs of complementary and alternative medicine (CAM). Materials and Methods: A systematic literature search was conducted in 11 electronic databases. All retrieved titles and reference lists were also hand-searched. Results: 38 publications were found: 23 on CAM of various definitions (medical and non-medical practitioners, over-the-counter products), 13 on homeopathy, 2 on phytotherapy. Studies investigated different kinds of costs (direct or indirect) and used different methods (prospective or retrospective questionnaires, data analyses, cost-effectiveness models). Most studies report 'out of pocket' costs, because CAM is usually not covered by health insurance. Costs per CAM-treatment / patient / month were AUD 7-66, CAD 250 and GBP 13.62 +/- 1.61. Costs per treatment were EUR 205 (range: 15-1,278), USD 414 +/- 269 and USD 1,127. In two analyses phytotherapy proved to be cost-effective. One study revealed a reduction of 1.5 days of absenteeism from work in the CAM group compared to conventionally treated patients. Another study, performed by a health insurance company reported a slight increase in direct costs for CAM. Costs for CAM covered by insurance companies amounted to approximately 0.2-0.5% of the total healthcare budget (Switzerland, 2003). Publications had several limitations, e.g. efficacy of therapies was rarely reported. As compared to conventional patients, CAM patients tend to cause lower costs. Conclusion: Results suggest lower costs for CAM than for conventional patients, but the limited methodological quality lowers the significance of the available data. Further well-designed studies and models are required.

A systematic review of the survival and complication rates of resin-bonded bridges after an observation period of at least 5 years

OBJECTIVES: The objectives of this systematic review were to assess the 5-year survival of resin-bonded bridges (RBBs) and to describe the incidence of technical and biological complications. METHODS: An electronic Medline search complemented by manual searching was conducted to identify prospective and retrospective cohort studies on RBBs with a mean follow-up time of at least 5 years. Patients had to have been examined clinically at the follow-up visit. Assessment of the identified studies and data extraction were performed independently by two reviewers. Failure and complication rates were analyzed using random-effects Poissons regression models to obtain summary estimates of 5-year proportions. RESULTS: The search provided 6110 titles and 214 abstracts. Full-text analysis was performed for 93 articles, resulting in 17 studies that met the inclusion criteria. Meta-analysis of these studies indicated an estimated survival of RBBs of 87.7% (95% confidence interval (CI): 81.6-91.9%) after 5 years. The most frequent complication was debonding (loss of retention), which occurred in 19.2% (95% CI: 13.8-26.3%) of RBBs over an observation period of 5 years. The annual debonding rate for RBBs placed on posterior teeth (5.03%) tended to be higher than that for anterior-placed RBBs (3.05%). This difference, however, did not reach statistical significance (P=0.157). Biological complications, like caries on abutments and RBBs lost due to periodontitis, occurred in 1.5% of abutments and 2.1% of RBBs, respectively. CONCLUSION: Despite the high survival rate of RBBs, technical complications like debonding are frequent. This in turn means that a substantial amount of extra chair time may be needed following the incorporation of RBBs. There is thus an urgent need for studies with a follow-up time of 10 years or more, to evaluate the long-term outcomes.