Spectroscopic study of Bioceramics for Endodontic and Orthopaedics

This thesis was aimed at investigating the physical-chemical properties and the behaviour in physiological environment of two classes of bioceramics: calcium silicate-based dental cements and alumina-based femoral heads for hip joint prostheses. The material characterization was performed using spectroscopic techniques such as that allow to obtain information on the molecular structure of the species and phases present in the analyzed samples. Raman, infrared and fluorescence spectroscopy was principally used. Calcium silicate cements, such as MTA (Mineral Trioxide Aggregate), are hydraulic materials that can set in presence of water: this characteristic makes them suitable for oral surgery and in particular as root-end filling materials. With the aim to improve the properties of commercial MTA cements, several MTA-based experimental formulations have been tested with regard to bioactivity (i.e. apatite forming ability) upon ageing in simulated body fluids. The formation of a bone-like apatite layer may support the integration in bone tissue and represents an essential requirement for osteoconduction and osteoinduction. The spectroscopic studies demonstrated that the experimental materials under study had a good bioactivity and were able to remineralize demineralized dentin. . Bioceramics thanks to their excellent mechanical properties and chemical resistance, are widely used as alternative to polymer (UHMWPE) and metal alloys (Cr-Co) for hip-joint prostesis. In order to investigate the in vivo wear mechanisms of three different generations of commercial bioceramics femoral heads (Biolox®, Biolox® forte, and Biolox® delta), fluorescence and Raman spectroscopy were used to investigate the surface properties and residual stresses of retrieved implants. Spectroscopic results suggested different wear mechanisms in the three sets of retrievals. Since Biolox® delta is a relatively recent material, the Raman results on its retrievals has been reported for the first time allowing to validate the in vitro ageing protocols proposed in the literature to simulate the effects of the in vivo wear.

Psychosoziale Belastung bei Herztransplantationskandidaten

Fragestellung: In der vorliegenden Untersuchung wurde geprüft, ob sich neu gelistete Herztransplantationskandidaten mit ischämischer Herzinsuffizienz (IKMP) und dilatativer Kardiomyopathie (DKMP) nach Kontrolle von Krankheitsschwere und Geschlecht in psychosozialen Variablen unterscheiden. Zudem wurde untersucht, ob psychosoziale Risikofaktoren für IKMP-Patienten stärker mit der 1-Jahres-Mortalität auf der Warteliste assoziiert sind als für DKMP-Patienten. Methode: Im Rahmen der multizentrischen, prospektiv angelegten Studie „Warten auf ein neues Herz“ bearbeiteten 160 DKMP- (16 % Frauen) und 122 IKMP-Patienten (13 % Frauen) kurz nach Aufnahme auf die Warteliste einen Fragebogen, der subjektiven Gesundheitszustand, Angst, Depressivität, soziale Unterstützung, Netzwerkgröße, Ärger, Ärgerausdruck und wartezeitspezifische Belastungen erfasste. Medizinische Daten zum Zeitpunkt der Listung und Veränderungen im Wartelistenstatus im 1-Jahres-Follow-Up wurden von Eurotransplant bereitgestellt. Ergebnisse: IKMP-Patienten waren im Vergleich mit DKMP-Patienten älter, häufiger ehemalige Raucher, hatten häufiger vorherige Herzoperationen erlebt, litten seltener unter einer Erregungsleitungsstörung, wurden seltener mit Aldosteronantagonisten sowie häufiger mit Katecholaminen behandelt. Nach Kontrolle dieser Variablen und unter Einbezug des Geschlechts berichteten nur Männer mit IKMP höhere Angstwerte und mehr Anger-In als Männer mit DKMP. Ein höheres Mortalitätsrisiko für IKMP-Patienten ein Jahr nach Aufnahme auf die Warteliste konnte nicht belegt werden. Auch zeigte sich keine Interaktion zwischen psychosozialer Belastung und Grunderkrankung hinsichtlich der Mortalität. Niedrige emotionale Unterstützung ging unabhängig von der Grunderkrankung mit einem dreifach erhöhten Mortalitätsrisiko einher. Fazit: Männer mit IKMP sind stärker durch negative Emotionen belastet als Männer mit DKMP. Eine weitere Risikogruppe stellen Personen mit niedriger emotionaler Unterstützung dar. Psychosoziale Risikofaktoren sollten daher bereits bei Aufnahme auf die Warteliste erfasst und Betreuungsangebote gezielt auf diese beiden Gruppen abgestimmt werden.

Romany Families in Romania: Intelligence and Personality of Children Cross-cultural and Specific Problems of Development

Psychogenetic research has emphasised the influence of social factors on a child's intellectual development. In her work, Ms. Dumitrascu examines two such factors; family size and order of birth. However, since these formal parameters tend to be unstable, other more informal factors should be taken into consideration. Of these, perhaps the most interesting is the "style" of parental education, which Ms. Dumitrascu regards as an expression of national traditions at the family level. This educational style is culture dependent. Only a comparative, cross-cultural study can reveal the real mechanism through which educational style influences the development of a child's intellect and personality. Ms. Dumitrascu conducted an experimental cross-cultural study aimed at examining the effects of the family environment on a child's intellectual development. Three distinct populations were involved in her investigation, each having quite a distinct status in their geographical area; Romanians, Romanies (Gypsies) from Romania, and Russians from the Republic of Moldova. She presented her research in the form of a series of articles written in English totalling 85 pages, and also on disc. A significant difference was revealed between the intelligence of a child living in a large family, and that of a child with no brothers or sisters. In the case of Romany children, the gap is remarkably large. Ms. Dumitrascu concludes that the simultaneous action of several negative factors (low socio-economic status, large family size, socio-cultural isolation of a population) may delay child development. Subjected to such a precarious environment, Romany children do not seek self-realisation, but rather struggle to survive the hardship. Most of them remain out of civilisation. Unfortunately, adult Romanies seldom express any concern regarding their children's successful social integration. The school as main socialisation tool has no value for most parents. Ms. Dumitrascu argues the need for a major effort aimed at helping Romany's social integration. She hopes this project will be of some help for psychologists, social workers, teachers, and all those who are interested in the integration into society of minority groups.

A Transformation of the Philosophical Thought of West European Liberalism in the Multi-National Central and South-Eastern European Milieu

This work was devoted to individual child development. Psychogenetic research has emphasised the importance of social factors in children's intellectual development and two social factors are looked at here, family size and birth order. The effect of the formal parameters is, however, very unstable and they should therefore be considered together with certain informal factors. Of these, parental educational style, which is an expression of national traditions at the family level, is of particular interest. Educational style is culture-dependent and only a comparative cross-cultural study can reveal the real mechanisms through which educational style influences children's intellectual and personality development. Dumitrascu carried out an experimental cross-cultural study dedicated to the effects of family environment on child intellectual development. This involved three distinct populations, each of which has a distinct status in their geographical area, namely Romanians, Romanies from Romania, and Russians from the Republic of Moldova. It showed a significant difference between child intelligence in those from large families and in only children, with a huge gap in the case of Romany children. This suggests that the simultaneous action of several negative factors (low socio-economic status, large family size, socio-cultural isolation of the population) may delay a child's development. Subjected to such a precarious environment, Romany children do not seek self-realisation but rather struggle to overcome hardship and the majority remain outside civilisation. Unfortunately, adult Romanies rarely show concern about their children's successful social integration, placing no value on the school as a major socialising tool. This leads to the conclusion that a major effort is needed to help Romanies' social integration.

Family Anomie and Juvenile Deliquency in Post-Communist Romania

The sensitivity of crime rates to social, economic and political influences has long aroused the interest of sociologists who have attempted to explain what kind of relationships might be associated with variations in crime rates between different social groups at different times. The earliest views were put forward by Emil Durkheim, and while later writers have developed (R.K. Merton, L. Srole, A, K. Cohen, etc.) have developed some aspects of his ideas further, his basic ideas of the divorce of the individual from normative standards and the lack of social integration are still valid. Ms. Voicu-Minea looked at the theoretical background in detail but then limited it to a specific social group, the family, asking first why certain individual within vulnerable families and/or negative social influences commit offences while others do not. In modern times the family has undergone massive structural and functional changes. Its former economic function, which once endowed it with a great capacity for social inclusion, has generally vanished, while its formerly crucial role in children's education has been massively reduced. These changes, which are still not complete, can lead to dysfunction and in certain social contexts such as that in post-communist Romanian society, this risk of dysfunction is still greater as unfavourably social circumstances more easily affect such families. The number of cases of juvenile delinquency in Romania has increased sharply ever since the end of the communist system and in 1996 reached the level of 18,317 cases. The sample examined included 1012 juvenile delinquents aged between 14 and 18, taken from all areas of Bucharest. Over 80% of charges related to theft, with more serious offences being relatively rare. The children underwent a series of psychological tests, accompanied by a questionnaire relating to family situation. The results showed that juvenile delinquency in Romania is overwhelmingly male, with 91.8% of offences being committed by boys. Two thirds of the research group were under the age of 16 and only just over one third attended school, with over half having left school before the legal age. While the majority of subjects had a lower than average level of education, they did not always recognise this, with two thirds seeing their level of education as being as good as or better than average. Nearly half the children (43%) did not live with both natural parents and majority came from families with three or more children. This applied both to their original families and to the families in which they were living at the time of the survey. The overwhelming majority of families were living in or around Bucharest, but under one third originated from there. Almost 25% of parents were under-schooled and around one third were unqualified workers. At least 30% of families lived in inadequate accommodation and family incomes were generally low. Ms. Voicu-Minea does however point out that over half the minors from the sample saw their family income as satisfactory or even more than satisfactory. When factors such as bad relationships between parents, corporal punishment, alcohol consumption and criminal records of family members were taken into account, the picture was bleak, making it understandable why over 36% of subjects had run away from home at least once, and in many cases repeatedly and for longer periods. The overwhelming majority of offences (80.8%) were committed in groups of between 2 and 11 persons, usually "friends" but in about 10% of cases member's of the family. IQ tests put about 75% of the sample at slightly under average, the difference being too slight to account for the behaviour problems of the majority. Personality tests, however, showed a different picture. Over 70% of those tested manifested an acute need of tenderness and a similar number a high level of potential aggressiveness. Almost half of the minors expressed such feelings as intolerance or a desire for revenge, and Ms. Voicu-Minea found a clear weakness of the Self. Around half the sample expressed sentiments of abandonment, renunciation and solitude.

Michael J. Fabricant and Robert Fisher: Settlement Houses Under Siege: The Struggle to Sustain Community Organisations in New York City

This is a fascinating book - clear, incisive, a lesson for our times. It focuses on the history and recent experience of Settlement Houses in New York and uses this as a vehicle for an analysis of the political economy of welfare agencies. I wanted to send copies to politicians and policy makers worldwide who, whilst claiming to support social inclusion, community regeneration and equal opportunities, formulate policies that fragment societies and oppress poor and vulnerable people.

Risks and Responsibilities? The Individualisation of Youth Transitions and the Ambivalence between Participation and Activation in Europe

This report provides insight on the situation facing young people in contemporary European societies in their transitions to work and citizenship. On the one hand, risks of exclusion have increased, while on the other, responsibilities for coping with such risks have been individualised, a state of affairs reinforced by the trend towards activation labour market policies. Drawing on the findings of a EU-funded study across nine European regions, the report gives evidence of the resulting biographical and policy dilemmas. Furthermore, it explores if and under what conditions the concept of participation may open new ways of reconciling systemic imperatives and individual needs in the social integration of young people.

Skin and mucosa care in systemic sclerosis - patients' and family caregivers' experiences and expectations of a specific education programme: a qualitative study

BACKGROUND Skin and mucosal manifestations such as skin thickening, pruritus, reduced microvascular circulation, digital lesions, appearance-related changes, and dryness of the eyes and mucosa are common in systemic sclerosis (SSc). A specific skin and mucosa care education programme for patients and their family caregivers should increase their self-efficacy and improve coping strategies. AIMS The aims of this qualitative study were to explore the participants' experiences of both everyday life with skin and mucosal manifestations and the programme itself, while identifying unmet needs for programme development. METHODS Narrative interviews were conducted with eight SSc patients and two family caregivers of individuals with SSc. Using qualitative content analysis techniques, the transcribed interviews were systematically summarized and categories inductively developed. RESULTS The findings illustrated participants' experiences of skin and mucosal symptoms and revealed them to be experts in finding the right therapy mix alone (before diagnosis) and also in collaboration with health professionals (after diagnosis). Participants emphasized that the programme gave them useful education on skin and mucosa care. They described how they had to cope alone with the lack of information on pathophysiology, people's reactions, and the impact on their family and working lives. Nevertheless, participants said that they maintained a positive attitude by not dwelling on future disabilities. CONCLUSIONS Patients and family caregivers benefited from the individualized and SSc-specific education on skin and mucosa care. Future improvements to the programme should focus on imparting understandable information on SSc pathophysiology, dealing with disfigurement and seeking reliable disease information, as well as facilitating peer support.

Agrarian learning processes in Switzerland 1918–1939

This paper examines the social impacts of weather extremes and the processes of social and communicative learning a society undertakes to find alternative ways to deal with the consequences of a crisis. In the beginning of the 20th Century hunger seemed to be expelled from Europe. Switzerland – like many other European countries – was involved in a global interdependent trade system, which provided necessary goods. But at the end of World War I very cold and wet summers in 1916/17 (causing crop failure) and the difficulties in war-trade led to malnutrition and enormous price risings of general living-standards in Switzerland, which shocked the people and caused revolutionary uprisings in 1918. The experience of malnutrition during the last two years of war made clear that the traditional ways of food supply in Switzerland lacked crisis stability. Therefore various agents in the field of food production, distribution and consumption searched for alternative ways of food supply. In that sense politicians, industrialists, consumer-groups, left-wing communitarians and farmers developed several strategies for new ways in food production. Traditionally there were political conflicts in Switzerland between farmers and consumers regarding price policies, which led mainly to the conflict in 1918. Consumers accused famers of holding back food to control extortionate prices while the farmers pointed to the bad harvest causing the price rising. The collaboration of these groups in search for new forms of food-stability made social integration possible again. In addition to other crisis-factors, weather extremes can have disastrous impacts and destroy a society’s self-confidence to its core. But even such crisis can lead to processes of substantial learning that allows a regeneration of confidence and show positive influence on political stabilization. The paper focuses on the process of learning and the alternative methods of food production that were suggested by various agents working in the field during the Interwar period. To achieve that goal documents of the various associations are analyzed and newspapers have been taken into consideration. Through the method of discourse-analysis of food-production during the Interwar period, possible solutions that crossed the minds of the agents should be brought to light.

Préparation à la transition de l'école obligatoire à la formation professionelle

Cette contribution analyse les contraintes et opportunités issus de la transition entre l’école obligatoire et la formation professionnelle en Suisse. L’ambition est de montrer que des facteurs psychologiques et structuraux sont essentiels pour comprendre les inégalités observées lors de cette transition. Les résultats de différentes études empiriques montrent que des facteurs associés à la personnalité, au support social, et à l’engagement personnel dans la préparation au choix de carrière ont une incidence sur les différences interindividuelles en termes d’adaptabilité de carrière et de congruence du choix professionnel tel qu’observés avant la transition. Les implications pour la pratique dans le domaine du conseil en orientation seront présentées.

Measuring College Student Satisfaction: A Multi-Year Study of the Factors Leading to Persistence

Using Tinto's (1987) social integration theory as a framework, this study measured student satisfaction in six transformative areas: educational experience, skills development, faculty interaction, personal growth, sense of community, and overall expectations. Emerging as a strategic planning process priority, this project sought to identify those areas where students succeeded or were at risk. Employing a three-phase mixed methods approach, this descriptive, longitudinal study was conducted from 1990-2004 at a highly selective specialized college and assisted college administrators in developing or modifying programs that would enhance student satisfaction to ensure degree completion.

Behavioral cognitions and factors related to hepatitis B vaccine acceptance and compliance in a cohort of drug users in Houston, Texas

Purpose. Drug users are a large group of those at highest risk for contracting Hepatitis B (HBV). This study sought to identify predictors of HBV vaccine acceptance and compliance in a cohort of current drug users in Houston, Texas. Perceived severity of HBV, perceived risk of HBV, perceived peer support of HBV vaccine, and perceived benefits of HBV vaccine were also examined assess their relationship to HBV compliance. ^ Methods. A randomized intervention study was conducted in a cohort of current drug users in Houston, Texas. Participants were recruited by community outreach workers from two urban neighborhoods in Houston known for high drug use. Participants were randomized to a standard vaccine schedule group or an accelerated vaccine schedule group. Participants were also randomized to either a standard behavioral intervention group or an enhanced behavioral intervention group designed to increase HBV vaccine acceptance and compliance. Baseline visits included an interview for demographic factors, drug and sexual behaviors, and HBV beliefs; and participants received the first dose of the HBV vaccine and one of the behavioral interventions. ^ Results. Of 1,643 screening participants, 77% accepted the HBV vaccine. Participants ages ≥50 were twice as likely to accept the vaccine. African Americans and less frequent drug users were also significantly more likely to accept the vaccine. Of the 1,259 participants who enrolled in the study, 75% were compliant to the HBV vaccine. Predictors of compliance were found to be race, housing status, and alcohol use. Speedball users were found to be 74% less likely to be compliant the HBV vaccine. None of the behavioral constructs assessed were found to significantly predict HBV compliance. However, additional analyses found that there were significant changes in mean scores of the behavioral concepts when measured at six month follow-up. ^ Conclusion. Results from this study indicate that when offered a free vaccine in the drug user community, a large percentage will be compliant to the vaccine series. The behavioral cognitions commonly used in HBV compliance research need to be extended to accurately fit this cohort. Also, vaccine intervention focus needs to be on reaching the homeless segment of the drug users and the speedball users. ^

The role of youth sports in public health

Study 1: Schools provide a range of opportunities for youth to be active, however, over the past decade, these opportunities have been declining. Sports teams are a promising venue to promote physical activity yet limited research has examined the gender an ethnic differences in sport participation. The purpose of this study is to examine trends in sport participation from 1991-2009 among US high school students. Secondly, we examined the association between gender and ethnicity with sports over time. This serial cross-sectional study used surveillance data from the Youth Risk Behavior Survey, a probability based sample weighted to represent gender and race/ethnic subpopulations of US high school students. The findings of this paper reveal persistent gender and ethnic disparities for sports participation among US youth. Since sports teams may provide a substantial source of physical activity, greater efforts should be undertaken to increase the participation of girls, especially minorities, in sports teams. ^ Study 2: Sports team participation is congruent with teaching and supporting healthy eating, yet limited research has examined the association between sports participation and dietary behaviors. This study aims to determine the association between youth sports participation and dietary behaviors among elementary-aged children. Significant dose-response associations were observed between number of sports teams and consumption of most fruits and vegetables. The likelihood of eating fruit for boys increased with the number of sports teams (1 team: OR=1.89; 3 teams: OR=3.44, p<0.001) and the likelihood of consuming green vegetables for girls was higher with the number of sports teams (1 team: OR=1.50; 3 teams: OR=2.39; p<0.001). For boys, the odds of consuming fruit-flavored drinks was higher ( p=0.019) and the odds of drinking soda was lower (p=0.018) with participation in increasing number of sports teams whereas for girls, sports participation was positively associated with diet soda consumption (p=0.006). ^ Study 3: Parents and peers have been shown to have a strong influence over the physical activity, dietary, and sedentary behaviors of youth. Youth sports teams have the potential to offer physical activity, displace sedentary behaviors, and promote a healthy diet. The purpose of this study is to assess how peer and parental support for physical activity and healthy eating, coupled with sport participation, is associated obesity related risk factors including diet and sedentary behaviors. A secondary analysis of data from the School Physical Activity and Nutrition study, a state-representative survey, was conducted. Eighth (n=3,931) and 11th (n=2,785) grade students were categorized into four groups based upon the level of peer and parental support derived from a three item scale and their participation in sports (sports/high support, sports/low support, no sports/high support, no sports/low support). Linear models were conducted to determine the difference in means between these groups for the following outcome variables: previous day fruit and vegetable intake, scores for an unhealthy and healthy food index, and hours spent watching television, playing video games, and working on a computer. Eighth graders had significantly greater levels of parental support for healthy eating and physical activity compared to 11th grade. Both 8 th and 11th graders in the sport/high support for healthy eating from peers and parents scored significantly higher on the healthy food index than other groups. Eighth and 11th graders in the sport/high support for physical activity from peers participated in fewer hours of sedentary behaviors than any other group (p ≤ 0.032). Although it is thought that sport participation may offer opportunities to support a healthy diet and displace sedentary time by offering providing physical activity, our study found that parental and peer support for activity and healthy eating may further attenuate this association. Parents and peer support should be an important target when developing strategies to improve healthy diets and reduce sedentary time among youth, especially in the context of youth sports. (Abstract shortened by UMI.)^

BIOMEDICAL LANGUAGE UNDERSTANDING AND EXTRACTION (BLUE-TEXT): A MINIMAL SYNTACTIC, SEMANTIC METHOD

Clinical text understanding (CTU) is of interest to health informatics because critical clinical information frequently represented as unconstrained text in electronic health records are extensively used by human experts to guide clinical practice, decision making, and to document delivery of care, but are largely unusable by information systems for queries and computations. Recent initiatives advocating for translational research call for generation of technologies that can integrate structured clinical data with unstructured data, provide a unified interface to all data, and contextualize clinical information for reuse in multidisciplinary and collaborative environment envisioned by CTSA program. This implies that technologies for the processing and interpretation of clinical text should be evaluated not only in terms of their validity and reliability in their intended environment, but also in light of their interoperability, and ability to support information integration and contextualization in a distributed and dynamic environment. This vision adds a new layer of information representation requirements that needs to be accounted for when conceptualizing implementation or acquisition of clinical text processing tools and technologies for multidisciplinary research. On the other hand, electronic health records frequently contain unconstrained clinical text with high variability in use of terms and documentation practices, and without commitmentto grammatical or syntactic structure of the language (e.g. Triage notes, physician and nurse notes, chief complaints, etc). This hinders performance of natural language processing technologies which typically rely heavily on the syntax of language and grammatical structure of the text. This document introduces our method to transform unconstrained clinical text found in electronic health information systems to a formal (computationally understandable) representation that is suitable for querying, integration, contextualization and reuse, and is resilient to the grammatical and syntactic irregularities of the clinical text. We present our design rationale, method, and results of evaluation in processing chief complaints and triage notes from 8 different emergency departments in Houston Texas. At the end, we will discuss significance of our contribution in enabling use of clinical text in a practical bio-surveillance setting.

La cohesión y la seguridad ciudadana : un enfoque global

El artículo revisa el concepto de cohesión social y la noción de seguridad, partiendo del análisis de los profundos desequilibrios y desigualdades sociales que el modelo económico dominante a escala global desde los años 1980 crea o intensifica en América Latina. Centrado en las transformaciones que generaron la pérdida de confianza en las instituciones, en el Estado, en el mercado del trabajo, en la educación, incluso en la religión y en la familia, sobre las cuales reposaba la solidaridad orgánica en el marco de la sociedad industrial capitalista, examina cinco indicadores de la existencia de problemas de inseguridad en relación con la cohesión social. Pone de relieve que el problema de la inseguridad se asocia con la ruptura o la fragilidad de los mecanismos de integración y de mediación social y sostiene la necesidad de reconstruir la cohesión social para alcanzar la seguridad ciudadana, destacando que este proceso se funda en una profunda modificación política, económica y social enfocada en la inclusión social, de la que son co-responsables el Estado y los ciudadanos como actores de su propio desarrollo.