The role of additive manufacturing in patient specific solutions

This dissertation investigates de role of the new additive manufacturing techniques in the treatment of pathologies with a patient-specific approach. Throughout this work the development methodology of these said products is explained in order to understand the different stages required to achieve a tailor made solution. The goal is to demonstrate the importance of the manufacturing technique and its capabilities to tailor-fit devices to patients and the adaptability of the process to tackle the most diverse situations. Three real cases are documented in order to prove the viability of the method and to showcase its advantages. Whenever possible patient-specific solutions are compared to their “off-the-shelf” counterparts in order to establish the pros and cons of each one of them. The dissertation is an insight into a possible future for the medical devices industry, where customization is expected to be the standard approach in the treatment of patients.

The impact of ethics education in medical laboratory science.

Teachers and students were asked what ethics education is offered in their program. The survey of the teachers regarding ethics education revealed some differences between english and french schools. It was found that franch schools favoured ethics courses taught by philosophers while english schools favoured ethics courses taught by health care providers. Furthermore, case studies were reported to be used more often in english schools and more often in assignments. However, regarless of the differences, 87 % of teachers agreed that ethics training is a high priority and most teachers thought that ethics training in their programs was adequate. At same time, students were asked to answer some questions that involved ethical dilemmas wherein some moral decisions would have to be made. Their responses revealed their level of moral development, based on Kohlberg's theory of moral development. The impact of ethics courses in the curriculum on moral development was correlated taking into account what ethics education students actually received with what year-of-study they were in (1st year, end of program or two years post graduation). Students were presented scenarios about falsifying records, communication, student dishonesty and preanalytical impact on patient care. These are authentic issues that technologists face on a daily basis. In reply to multiple-choice questions, respondents chose, in order of personal preference, the three best answers out of six offered to complete a statement regarding ethics. Statistical analysis was performed using SPSS (Statistical Package for Social Studies), employing crosstabulations and Oneway Anova. Factors including respondents age range, mother tongue, gendre, and years of schooling were considered.

Re-imagining the theology of human sexuality in the Methodist Church: the use of narrative in theological methodology

This thesis proposes the development of a narrative methodology in the British Methodist Church. Such a methodology embraces and communicates both felt experience and critical theological thinking, thus producing and presenting a theology that might have a constructive transformative impact on wider society. In chapter one I explore the ways in which the Church speaks in public, identify some of the challenges it faces, and consider four models of engagement. If the Church is to engage in public discourses then I argue that its words need to be relevant and connect with people’s experiences. To ground the thinking I focus on the context of the British Methodist Church and explore how the Church engages in theological reflection through the lens of its thinking on issues of human sexuality. Chapter two reviews how theological reflection is undertaken in the British Methodist Church. I describe how the Methodist Quadrilateral of Scripture, tradition, reason and experience remains a foundational framework for theological reflection within the Methodist Church and consider the impact of institutional processes and the ways in which the Methodist people actually engage with theological thinking. The third and fourth chapters focus on how the British Methodist Church has produced its theology of human sexuality, giving particular attention to the use of personal and sexual stories in this process. I find that whilst there has been a desire to listen to the stories of the Methodist people, there has not been a corresponding interrogation or analysis of their stories so as to enable robust and constructive theological reflection on these experiences. Using resources from Foucauldian approaches to discourse analysis, I critique key statements and the processes involved in their production, offering an analysis of this body of theological thinking and indicating where possibilities for alternative ways of thinking and acting arise. The proposed methodology draws upon resources from social science methodologies, and in chapter five I look at the use of personal experience and relevant strategies of inquiry that prompt reflection on the hermeneutical process and employ narrative approaches in undertaking, analysing and presenting research. The exploration shows that qualitative research methodologies offer resources and methods of inquiry that could help the Church to engage with personal stories in its theological thinking in a robust, interrogative and imaginative way. In chapter six an examination of story and narrative is undertaken, to show how they have been understood as ways of knowing and how they relate to theological inquiry. Whilst acknowledging some of the limitations of narrative, I indicate how it offers constructive possibilities for theological reflection and could be a means for the British Methodist Church to engage in public discourse. This is explored further in chapter seven, which looks in more detail at how the British Methodist Church has used narrative in its theological thinking, and outlines areas requiring further attention in order for a narrative theological methodology to be developed, namely: attention to the question ‘whose experience?’; investigation of issues of power and the dynamics involved in the process of the production of theological thought; how personal stories and experiences are interrogated and how narrative is constructed; and how narrative might be employed within the Methodist Quadrilateral. The final chapter considers the advantages and limitations of such an approach, whether the development of such a method is possible in the Methodist Church today and its potential for helping the Church to engage in public discourse more effectively. I argue that this methodology can provoke new theological insights and enable new ways of being in the world

The teaching of reading English in a foreign language in Libyan universities: methods and models

This study focuses on the learning and teaching of Reading in English as a Foreign Language (REFL), in Libya. The study draws on an action research process in which I sought to look critically at students and teachers of English as a Foreign Language (EFL) in Libya as they learned and taught REFL in four Libyan research sites. The Libyan EFL educational system is influenced by two main factors: the method of teaching the Holy-Quran and the long-time ban on teaching EFL by the former Libyan regime under Muammar Gaddafi. Both of these factors have affected the learning and teaching of REFL and I outline these contextual factors in the first chapter of the thesis. This investigation, and the exploration of the challenges that Libyan university students encounter in their REFL, is supported by attention to reading models. These models helped to provide an analytical framework and starting point for understanding the many processes involved in reading for meaning and in reading to satisfy teacher instructions. The theoretical framework I adopted was based, mainly and initially, on top-down, bottom-up, interactive and compensatory interactive models. I drew on these models with a view to understanding whether and how the processes of reading described in the models could be applied to the reading of EFL students and whether these models could help me to better understand what was going on in REFL. The diagnosis stage of the study provided initial data collected from four Libyan research sites with research tools including video-recorded classroom observations, semi-structured interviews with teachers before and after lesson observation, and think-aloud protocols (TAPs) with 24 students (six from each university) in which I examined their REFL reading behaviours and strategies. This stage indicated that the majority of students shared behaviours such as reading aloud, reading each word in the text, articulating the phonemes and syllables of words, or skipping words if they could not pronounce them. Overall this first stage indicated that alternative methods of teaching REFL were needed in order to encourage ‘reading for meaning’ that might be based on strategies related to eventual interactive reading models adapted for REFL. The second phase of this research project was an Intervention Phase involving two team-teaching sessions in one of the four stage one universities. In each session, I worked with the teacher of one group to introduce an alternative method of REFL. This method was based on teaching different reading strategies to encourage the students to work towards an eventual interactive way of reading for meaning. A focus group discussion and TAPs followed the lessons with six students in order to discuss the 'new' method. Next were two video-recorded classroom observations which were followed by an audio-recorded discussion with the teacher about these methods. Finally, I conducted a Skype interview with the class teacher at the end of the semester to discuss any changes he had made in his teaching or had observed in his students' reading with respect to reading behaviour strategies, and reactions and performance of the students as he continued to use the 'new' method. The results of the intervention stage indicate that the teacher, perhaps not surprisingly, can play an important role in adding to students’ knowledge and confidence and in improving their REFL strategies. For example, after the intervention stage, students began to think about the title, and to use their own background knowledge to comprehend the text. The students employed, also, linguistic strategies such as decoding and, above all, the students abandoned the behaviour of reading for pronunciation in favour of reading for meaning. Despite the apparent efficacy of the alternative method, there are, inevitably, limitations related to the small-scale nature of the study and the time I had available to conduct the research. There are challenges, too, related to the students’ first language, the idiosyncrasies of the English language, the teacher training and continuing professional development of teachers, and the continuing political instability of Libya. The students’ lack of vocabulary and their difficulties with grammatical functions such as phrasal and prepositional verbs, forms which do not exist in Arabic, mean that REFL will always be challenging. Given such constraints, the ‘new’ methods I trialled and propose for adoption can only go so far in addressing students’ difficulties in REFL. Overall, the study indicates that the Libyan educational system is underdeveloped and under resourced with respect to REFL. My data indicates that the teacher participants have received little to no professional developmental that could help them improve their teaching in REFL and skills in teaching EFL. These circumstances, along with the perennial problem of large but varying class sizes; student, teacher and assessment expectations; and limited and often poor quality resources, affect the way EFL students learn to read in English. Against this background, the thesis concludes by offering tentative conclusions; reflections on the study, including a discussion of its limitations, and possible recommendations designed to improve REFL learning and teaching in Libyan universities.

Pedagogical Mediation for the Autonomy of Future Professionals in Teacher Training

This article studies the importance of pedagogical mediation in helping first-year students in the Teacher Training area to advance from intellectual heteronomy to intellectual autonomy. It explains some strategies and experiences implemented by the authors. It focuses on the need of paying attention to students in order to understand their expectations, opinions and previous experiences as a basis for developing different topics and concepts, to favor an actual free participation in the pedagogical mediation dynamics and, consequently, opportunities for students to express themselves with autonomy. The aforementioned strategies allow for the transition from a pedagogy centered on teaching to a pedagogy centered on learning, in such a way that the future educator becomes a protagonist in his/her formation and constructs his/her own intellectual identity, based on the concept of action-reflection-action. The authors of this article consider that the first year in higher education is a privileged opportunity to develop the autonomy of future teachers, and, as stated by Freire (2004), the respect for autonomy is an ethical imperative.

Analysis of spatial variation of tree heights in an urban area using LiDAR data.

Estimating with greater precision and accuracy the height of plants has been a challenge for the scientific community. The objective this study is to evaluate the spatial variation of tree heights at different spatial scales in areas of the city of Recife, Brazil, using LiDAR remote sensing data. The LiDAR data were processed in the QT Modeler (Quick Terrain Modeler v. 8.0.2) software from Applied Imagery. The TreeVaW software was utilized to estimate the heights and crown diameters of trees. The results obtained for tree height were consistent with field measurements.

The management of schools’ websites in Cantabria, Spain

School websites are not only sources of information and documentation, but also means of communication that are increasingly being accessed by members of society, especially by the different educational communities, thanks to the democratisation of Internet access. This paper deals with a qualitative research project in which information and communication technology coordinators of infant and primary publicly funded private schools (concertados) and state schools in urban, rural and semi-urban/rural areas within the Region of Cantabria (Spain) were interviewed in order to understand how school websites are managed. The findings show a range of views and practices in the schools’ management of their websites, some positive developments in their uses and functions, and numerous opportunities for improvement. School websites are essential communication tools, which need to be continuously improved/updated by their managers, with the support of the education authorities.

Emotions in legal decisions: the construction of objective narratives in Italian criminal trials

Drawing on ethnographic data collected in Italian courts and prosecution offices, this dissertation offers new perspectives on legal decision-making by highlighting the importance of emotions for constructing and evaluating legal narratives. Focusing on criminal cases, it describes and dissects how judges and prosecutors use emotions in reflection and action tied to lay narratives and legal constraints. The analysis shows that legal professionals engage in different types of emotional dynamics when dealing with stories; first, they develop gut feelings, which are either endorsed or kept at distance by means of emotional reflexivity, to comply with legal ideals of objectivity and impartiality. Second, empathy emerges as a crucial tool to direct the interaction with lay people and to interpret legal prerequisites, such as credibility, and intent. Finally, the dissertation shows that lay stories lead legal professionals to become passionate and committed towards the correct application of the law, the restoration of the moral order, and the achievement of justice. In light of the empirical findings, this thesis strives to develop a theoretical understanding of legal decision-making as narrative work that includes emotional dynamics consistent with rational, objective action.

Augmented Audiovisual Translation: the Perks and Perils of the Implementation of Artificial Intelligence in Subtitling and Dubbing

This thesis examines the state of audiovisual translation (AVT) in the aftermath of the COVID-19 emergency, highlighting new trends with regards to the implementation of AI technologies as well as their strengths, constraints, and ethical implications. It starts with an overview of the current AVT landscape, focusing on future projections about its evolution and its critical aspects such as the worsening working conditions lamented by AVT professionals – especially freelancers – in recent years and how they might be affected by the advent of AI technologies in the industry. The second chapter delves into the history and development of three AI technologies which are used in combination with neural machine translation in automatic AVT tools: automatic speech recognition, speech synthesis and deepfakes (voice cloning and visual deepfakes for lip syncing), including real examples of start-up companies that utilize them – or are planning to do so – to localize audiovisual content automatically or semi-automatically. The third chapter explores the many ethical concerns around these innovative technologies, which extend far beyond the field of translation; at the same time, it attempts to revindicate their potential to bring about immense progress in terms of accessibility and international cooperation, provided that their use is properly regulated. Lastly, the fourth chapter describes two experiments, testing the efficacy of the currently available tools for automatic subtitling and automatic dubbing respectively, in order to take a closer look at their perks and limitations compared to more traditional approaches. This analysis aims to help discerning legitimate concerns from unfounded speculations with regards to the AI technologies which are entering the field of AVT; the intention behind it is to humbly suggest a constructive and optimistic view of the technological transformations that appear to be underway, whilst also acknowledging their potential risks.

[the Teaching Of Social Sciences In Health: Between Practice And Theory].

The models of teaching social sciences and clinical practice are insufficient for the needs of practical-reflective teaching of social sciences applied to health. The scope of this article is to reflect on the challenges and perspectives of social science education for health professionals. In the 1950s the important movement bringing together social sciences and the field of health began, however weak credentials still prevail. This is due to the low professional status of social scientists in health and the ill-defined position of the social sciences professionals in the health field. It is also due to the scant importance attributed by students to the social sciences, the small number of professionals and the colonization of the social sciences by the biomedical culture in the health field. Thus, the professionals of social sciences applied to health are also faced with the need to build an identity, even after six decades of their presence in the field of health. This is because their ambivalent status has established them as a partial, incomplete and virtual presence, requiring a complex survival strategy in the nebulous area between social sciences and health.

The Effect Of Pelvic Floor Muscle Training Alone Or In Combination With Electrostimulation In The Treatment Of Sexual Dysfunction In Women With Multiple Sclerosis.

Sexual dysfunction (SD) affects up to 80% of multiple sclerosis (MS) patients and pelvic floor muscles (PFMs) play an important role in the sexual function of these patients. The objective of this paper is to evaluate the impact of a rehabilitation program to treat lower urinary tract symptoms on SD of women with MS. Thirty MS women were randomly allocated to one of three groups: pelvic floor muscle training (PFMT) with electromyographic (EMG) biofeedback and sham neuromuscular electrostimulation (NMES) (Group I), PFMT with EMG biofeedback and intravaginal NMES (Group II), and PFMT with EMG biofeedback and transcutaneous tibial nerve stimulation (TTNS) (Group III). Assessments, before and after the treatment, included: PFM function, PFM tone, flexibility of the vaginal opening and ability to relax the PFMs, and the Female Sexual Function Index (FSFI) questionnaire. After treatment, all groups showed improvements in all domains of the PERFECT scheme. PFM tone and flexibility of the vaginal opening was lower after the intervention only for Group II. All groups improved in arousal, lubrication, satisfaction and total score domains of the FSFI questionnaire. This study indicates that PFMT alone or in combination with intravaginal NMES or TTNS contributes to the improvement of SD.

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.

Mesenchymal Stromal Cells From Adipose Tissue Attached To Suture Material Enhance The Closure Of Enterocutaneous Fistulas In A Rat Model.

Surgical treatment for enterocutaneous fistulas (EF) frequently fails. Cell therapy may represent a new approach to treatment. Mesenchymal stromal cells (MSCs) have high proliferative and differentiation capacity. This study aimed to investigate whether MSCs could adhere to suture filament (SF), promoting better EF healing. MSCs, 1 × 10(6), from adipose tissue (ATMSCs) were adhered to a Polyvicryl SF by adding a specific fibrin glue formulation. Adhesion was confirmed by confocal and scanning electron microscopy (SEM). A cecal fistula was created in 22 Wistar rats by incising the cecum and suturing the opening to the surgical wound subcutaneously with four separate stitches. The animals were randomly allocated to three groups: control (CG)-five animals, EF performed; injection (IG)-eight animals 1 × 10(6) ATMSCs injected around EF borders; and suture filament (SG): nine animals, sutured with 1 × 10(6) ATMSCs attached to the filaments with fibrin glue. Fistulas were photographed on the operation day and every 3 days until the 21st day and analyzed by two observers using ImageJ Software. Confocal and SEM results demonstrated ATMSCs adhered to SF (ATMSCs-SF). The average reduction size of the fistula area at 21st day was greater for the SG group (90.34%, P < 0.05) than the IG (71.80%) and CG (46.54%) groups. ATMSCs adhered to SF maintain viability and proliferative capacity. EF submitted to ATMSCs-SF procedure showed greater recovery and healing. This approach might be a new and effective tool for EF treatment.

The Prevalence Of Tic Disorders In Children And Adolescents In Brazil.

Tourette syndrome (TS) and tic disorders represent events of familiar magnitude characterized by involuntary movements and/or vocalization. To determine the prevalence of TS/tic disorders we studied a sample of 762 subjects (388 M, 374 F), between 1992 and 1997, age 6 to 43 years old, taken out of a population of 10,155 subjects (4,918 M, 5,237 F; age: 3-56 years old). A structured 4-item questionnaire, direct interview (multistaged), >1 yr follow-up, were used. 9,565 subjects (4,614 M, 4,951 F) sent back the questionnaires, 3,354 of these (1,671 M, 1,683 F) with positive answers to tics. 42 subjects (31 M, 11 F, age: 7-21 years old, mean: 11 years old) met the DSM-III-R criteria. The total minimal prevalence of TS is 0.43%, with a 3:1 ratio male/female. The minimal prevalence of chronic tic disorder is 2.27%. The total minimal prevalence for tic disorders at all is 2.91%. No special education students participation.

Transition From Glass To Digital Slide Microscopy In The Teaching Of Oral Pathology In A Brazilian Dental School.

Several medical and dental schools have described their experience in the transition from conventional to digital microscopy in the teaching of general pathology and histology disciplines; however, this transitional process has scarcely been reported in the teaching of oral pathology. Therefore, the objective of the current study is to report the transition from conventional glass slide to virtual microscopy in oral pathology teaching, a unique experience in Latin America. An Aperio ScanScope® scanner was used to digitalize histological slides used in practical lectures of oral pathology. The challenges and benefits observed by the group of Professors from the Piracicaba Dental School (Brazil) are described and a questionnaire to evaluate the students' compliance to this new methodology was applied. An improvement in the classes was described by the Professors who mainly dealt with questions related to pathological changes instead of technical problems; also, a higher interaction with the students was described. The simplicity of the software used and the high quality of the virtual slides, requiring a smaller time to identify microscopic structures, were considered important for a better teaching process. Virtual microscopy used to teach oral pathology represents a useful educational methodology, with an excellent compliance of the dental students.