Developing markets of energy biomass – local and global perspectives

The thesis explores global and national-level issues related to the development of markets for biomass for energy. The thesis consists of five separate papers and provides insights on selected issues. The aim of Paper I was to identify methodological and statistical challenges in assessing international solid and liquid biofuels trade and provide an overview of the Finnish situation with respect to the status of international solid and liquid biofuels trade. We found that, for the Finnish case, it is possible to qualify direct and indirect trade volumes of biofuels. The study showed that indirect trade of biofuels has a highly significant role in Finland and may be a significant sector also in global biofuels trade. The purpose of Paper II was to provide a quantified insight into Finnish prospects for meeting the national 2020 renewable energy targets and concurrently becoming a largescale producer of forest-biomass-based second-generation biofuels for feeding increasing demand in European markets. We found that Finland has good opportunities to realise a scenario to meet 2020 renewable energy targets and for large-scale production of wood-based biofuels. The potential net export of transport biofuels from Finland in 2020 would correspond to 2–3% of European demand. Paper III summarises the global status of international solid and liquid biofuels trade as illuminated by several separate sources. International trade of biofuels was estimated at nearly 1 EJ for 2006. Indirect trade of biofuels through trading of industrial roundwood and material by-products comprises the largest proportion of the trading, with a share of about two thirds. The purpose of Paper IV was to outline a comprehensive picture of the coverage of various certification schemes and sustainability principles relating to the entire value-added chain of biomass and bioenergy. Regardless of the intensive work that has been done in the field of sustainability schemes and principles concerning use of biomass for energy, weaknesses still exist. The objective of Paper V was to clarify the alternative scenarios for the international biomass market until 2020 and identify the underlying steps needed toward a wellfunctioning and sustainable market for biomass for energy purposes. An overall conclusion drawn from this analysis concerns the enormous opportunities related to the utilisation of biomass for energy in the coming decades.

Effective Social Intranet. Case: Mobile Routing Business Unit, Tellabs

The purpose of this thesis is to examine what the normative, effective social Intranet solution is for Tellabs Mobile Routing business unit in terms of sharing knowledge more openly and effectively, fostering innovation, and improving team spirit and positive employee experience. Additionally, these aspects are researched from the intra- and inter-organizational points of view. The research is based on previous literature and empirical interviews. Based on these two items, an eight-fold recommendation proposal was created to change the current Intranet to become an effective social Intranet.

Serum neutralization with different types and subtypes of bovine herpesvirus 1 and 5

The serum neutralization (SN) test is the gold standard method to measure neutralizing antibodies to bovine herpesviruses. However, in view of the further subdivisions of bovine herpesviruses in types/subtypes, defining which virus to use at challenge in SN tests may be difficult. In view of that, this study was carried out to re-evaluate (SN) sensitivity with different types/subtypes of bovine herpesviruses types 1 (BoHV-1) and 5 (BoHV-5) as challenge viruses. Bovine sera (n=810) were collected from two distinct geographic regions and tested by SN with three type 1 viruses (BoHV-1.1 strains "Los Angeles" and "EVI123/98"; BoHV-1.2a strain "SV265/96") and three type 5 viruses (BoHV-5a strain "EVI88/95"; BoHV-5b strain "A663" and BoHV-5c "ISO97/95"). SN tests were performed with a 1 hour incubation of the serum-virus mixtures at 37ºC against 100 TCID50 of each of the viruses. SN sensitivity varied greatly depending on the challenge virus used in the test. The highest sensitivity (327 positive/810 total sera tested; 40.37%) was attained when the positive results to the six viruses were added together. No association could be found between any particular type or subtype of virus and the sensitivity of the test. When positive results to each single strain were considered, SN sensitivity varied from 41.7% to 81.7%, depending on the virus and the geographic region of origin of the sera. Variation was detected even when challenge viruses belonged to the same subtype, where disagreement between positive results reached 41%. These results indicate that one hour incubation SN tests against single viruses, as performed here, may display a significantly low sensitivity (p=0.05); performing SN tests against a number of different viruses may increase considerably SN sensitivity. Furthermore, the choice of virus used for challenge is critical in SN tests. In addition, sera from different geographic regions may give rise to disagreeing results with different strains of BoHV-1 and BoHV-5. This might be particularly relevant for control programs and in international trade, were maximum sensitivity should be targeted.

Das persönliche Glück auf dem unpersönlichen Markt. Deutsche und finnische Kontaktanzeigen im 20. Jahrhundert - eine kontrastive und diachrone Textsortenuntersuchung

Min avhandling är en diakronisk och kontrastiv undersökning av texttyper. Forskningsmaterialet består av kontaktannonser i tidningarna Süddeutsche Zeitung och Helsingin Sanomat under tiden 1900 – 1999. Materialet består av 652 tyska och 538 finska annonser. De undersökta annonserna har publicerats i maj och har samlats från ovannämnda tidningar vart tionde år. Materialet har analyserats med ett statistiskt SPSS-program. I avhandlingen analyseras utvecklingen av ovannämnda texttyp under hundra år i två olika kulturer, den tyska och den finska. Syftet med avhandlingen är att med hjälp av detta material finna språkliga och kulturella likheter och skillnader i kontaktannonser. Utgångspunkten är att språkliga uttryck avspeglar sin tids samhälleliga värderingar, vilka således också påverkar sökandet efter en livskamrat. Analysresultaten granskas sålunda i ett större samhälleligt sammanhang under olika decennier. Annonstexterna undersöks dock inte utgående från enskilda samhälleliga skeenden. Avhandlingen analyserar 13 olika informationsenheter i kontaktannonserna, huruvida dessa enheter förekommer under hela den aktuella perioden och om samma informationsenheter förekommer i annonser i de båda kulturerna. Avhandlingen är sålunda intra- och interlingual samt interkulturell. Genom denna metod får man fram de kännetecken som är betecknande för denna texttyp under en viss tid i de bägge kulturerna. Avhandlingen är indelad i tre delar. Den första delen ger bakgrundsinformation om äktenskapets och familjebegreppets historia samt om uppkomsten av den tyska och finska pressen. Den andra teoretiska delen behandlar text- och texttyplingvistik samt nuvarande forskning inom dessa områden. Den tredje och mest omfattade delen består av en kvalitativ och kvantitativ analys, som omfattar 11 olika forskningsdelar. Undersökningen visar att man i texttypen kontaktannonser kan upptäcka skillnader t ex redan däri att en tysk annons skiljer sig från en finsk vad längd och informationsmängd beträffar. En finsk annons förlitar sig i sin språkliga knapphet på att läsaren förstår kontexten i texttypen. Av avhandlingen framgår också att vid analys av texttyper bör deras historiska och kulturella kontext beaktas, eftersom analysen påvisar att texttyperna är historie- och kulturbundna.

Development of a Real-time PCR test for porcine group A rotavirus diagnosis

Group A Rotavirus (RVA) is one of the most common causes of diarrhea in humans and several animal species. A SYBR-Green Real-Time polymerase chain reaction (PCR) was developed to diagnose RVA from porcine fecal samples, targeting amplification of a 137-bp fragment of nonstructural protein 5 (NSP5) gene using mRNA of bovine NADH-desidrogenase-5 as exogenous internal control. Sixty-five samples were tested (25 tested positive for conventional PCR and genetic sequencing). The overall agreement (kappa) was 0.843, indicating 'very good' concordance between tests, presenting 100% of relative sensitivity (25+ Real Time PCR/25+ Conventional PCR) and 87.5% of relative sensitivity (35- Real Time PCR/40- Conventional PCR). The results also demonstrated high intra- and inter-assay reproducibility (coefficient of variation ≤1.42%); thus, this method proved to be a fast and sensitive approach for the diagnosis of RVA in pigs.

Nordic alcohol policy in Europe: the adaptation of Finland’s, Sweden’s and Norway’s alcohol policies to a new policy framework, 1994-2013

The purpose of this thesis is to study how and to which extent Finland, Sweden and Norway have adapted their alcohol policies to the framework imposed to them by the EU and the European Economic Area (EEA) since the mid-1990s. This is done by studying the underlying mechanisms that have influenced the formation of alcohol policy in the Nordic countries in that period. As a part of this analysis main differences in alcohol policies and alcohol consumption between the three countries are assessed and the phenomenon of cross-border trade with alcohol is discussed. The study examines also the development of Finnish, Norwegian and Swedish alcohol policies between 1994 and 2012 and compares the Nordic alcohol policies with other alcohol policies in Europe as the situation was in 2012. The time frame of the study spans from the mid-1990s to the end of 2013 and is divided into three phases. Studying the role of the Europeanisation process on the formation of alcohol policies has a key role in the analysis. Besides alcohol policies, the analyses comprise the development of alcohol consumption and cross-border trade with alcohol. In addition, a quantitative scale constructed to measure the strictness of alcohol policies is utilised in the analyses. The results from the scale are used to substantiate the qualitative analysis and to test whether the stereotypical view of a strict Nordic alcohol policy is still true. The results from the study clearly corroborate earlier findings on the significance of Europeanisation and the Single Market for the development of alcohol policies in the Nordic countries. Free movement of goods and unhindered competition have challenged the principle of disinterest and enabled private profit seeking in alcohol trade. The Single Market has also contributed to the increase in availability of alcohol and made it more difficult for the Nordic EU member states to maintain restrictive alcohol policies. All in all, alcohol policies in the Nordic countries are more liberal in 2013 than they were in 1994. Norway, being outside the EU has, however, managed to maintain a stricter alcohol policy than Finland and Sweden. Norway has also been spared from several EU directives that have affected Finland and Sweden, the most remarkable being the abolishment of the travellers’ import quotas for alcohol within the EU. Due to its position as a non-EU country Norway has been able to maintain high alcohol taxes without being subjected to a ”race to the bottom” regarding alcohol taxes the same way as Finland and Sweden. Finland distinguishes as the country that has liberalised its alcohol policy most during the study period. The changes in alcohol policies were not only induced by Europeanisation and the Single Market, but also by autonomous decision-making and political processes in the individual countries. Furthermore, the study shows that alcohol policy measures are implemented more widely in Europe than before and that there is a slow process of convergence going on regarding alcohol policy in Europe. Despite this, alcohol policies in the Nordic countries are still by far the strictest in all of Europe. From a Europeanisation perspective, the Nordic countries were clearly on the receiving end during the first two study phases (1994–2007), having more to adjust to rules from the EU and the Single Market than having success in uploading and shaping alcohol policy on the European and international field. During the third and final study phase (2008–2013), however, the Nordic countries have increasingly succeeded in contributing to shape the alcohol policy arena in the EU and also more widely through the WHOs global alcohol strategy. The restrictive Nordic policy tradition on which the current alcohol policies in Finland, Sweden and Norway were built on has still quite a solid evidence base. Although the basis of the restrictive alcohol policy has crumbled somewhat during the past twenty years and the policies have become less effective, nothing prevents it from being the base for alcohol policy in the Nordic countries even in the long term. In the future, all that is needed for an effective and successful alcohol policy is a solid evidence base, enough political will and support from the general public.

In situ enzyme immunoassay for titration of a Brazilian hepatitis A virus strain (HAF-203)

Hepatitis A virus (HAV) replicates relatively slowly in cell culture without a cytopathic effect, a fact that limits the use of tissue culture assays. The radioimmunofocus assay is the standard method for HAV titration, although it is labor intensive and requires the use of radioisotopes. A simple, rapid and objective infectivity assay based on an in situ enzyme immunoassay (EIA) is described here for a Brazilian cell culture-adapted HAV strain (HAF-203). The assay uses a peroxidase-labeled polyclonal antibody to fixed monolayers as an indicator of infection. EIA may be completed within 7 days using serial 5-fold dilutions of the virus, yielding a titer of 5.024 log 50% tissue culture infective dose (TCID50)/ml for HAF-203. This technique had a detection limit of 1.1 log TCID50/ml and the specificity was demonstrated by detecting no reaction on the columns of uninfected wells. The reproducibility (with intra- and inter-assay coefficients of variation ranging from 1.9 to 3.8% and from 3.5 to 9.9%, respectively) and quantitation of the assay were demonstrated by close agreement in virus infectivity titers among different assays of the same amount of virus and between assays of different amounts of virus. Furthermore, this assay does not require the use of radiolabeled antibodies. We describe here an efficient EIA that is highly reproducible and that could be used to monitor HAV growth in cell culture and to determine the quantity of HAV antigen needed for diagnostic assays. This is the first report of the infectious titer of the Brazilian cell culture-adapted HAV strain (HAF-203).

Effects of systemic administration of ciliary neurotrophic factor on Bax and Bcl-2 proteins in the lumbar spinal cord of neonatal rats after sciatic nerve transection

Ciliary neurotrophic factor (CNTF) is a cytokine that plays a neuroprotective role in relation to axotomized motoneurons. We determined the effect of daily subcutaneous doses of CNTF (1.2 µg/g for 5 days; N = 13) or PBS (N = 13) on the levels of mRNA for Bcl-2 and Bax, as well as the expression and inter-association of Bcl-2 and Bax proteins, and the survival of motoneurons in the spinal cord lumbar enlargement of 2-day-old Wistar rats after sciatic nerve transection. Five days after transection, the effects were evaluated on histological and molecular levels using Nissl staining, immunoprecipitation, Western blot analysis, and reverse transcriptase-polymerase chain reaction. The motoneuron survival ratio, defined as the ratio between the number of motoneurons counted on the lesioned side vs those on the unlesioned side, was calculated. This ratio was 0.77 ± 0.02 for CNTF-treated rats vs 0.53 ± 0.02 for the PBS-treated controls (P < 0.001). Treatment with CNTF modified the level of mRNA, with the expression of Bax RNA decreasing 18% (with a consequent decrease in the level of Bax protein), while the expression of Bcl-2 RNA was increased 87%, although the level of Bcl-2 protein was unchanged. The amount of Bcl-2/Bax heterodimer increased 91% over that found in the PBS-treated controls. These data show, for the first time, that the neuroprotective effect of CNTF on neonatal rat axotomized motoneurons is associated with a reduction in free Bax, due to the inhibition of Bax expression, as well as increased Bcl-2/Bax heterodimerization. Thus, the neuroprotective action of the CNTF on axotomized motoneurons can be related to the inhibition of this apoptotic pathway.

Barriers to Service-sector SME Internationalization in the EU Business Environment

The service sector in the global world is constantly growing: in Europe, they account currently approximately for 70 per cent of the total economy. Yet service internationalization is rather a new phenomenon: services have been traditionally seen as local entities, which also explains why research on service internationalization has properly begun only few decades ago. Even though the Single European Market allows free service movement between Member States, services do not move as actively as desired: approximately only one fifth of services are involved in cross-border trade. Therefore, the main purpose of this thesis is to analyze the barriers to service-sector SME internationalization in the EU business environment. To address the research purpose, the internationalization of service-sector SMEs in the EU area is first described and thereafter, the barriers to service-sector SME internationalization in the European context are mapped and analyzed from intra- and extra-firm perspectives. In order to understand the topic area and the phenomenon, a short glance is first taken into Europe as a business environment for service industries: the market characteristics and benefits of the common free trade area for service industries are described. Also earlier literature on service internationalization and barriers to international service trade are discussed. Due to low previous research activity on barriers specifically to international service trade, the discussion is improved by presenting general findings of barriers to SME internationalization. This research is conducted with qualitative methods: there is only a limited amount of previous research and qualitative methods provide a way of gathering in-depth information and reaching understanding from respondents’ perspectives. The evidence presented in the study was collected through six semi-structured interviews with six different small or medium sized international service firm representatives that all had the first-hand knowledge regarding their company’s process of delivering services from home market to other European countries. The results of the study provide a detailed description and analysis of intra- and extra-firm barriers to service-sector SME internationalization in the context of EU and indicate that in general, internal firm-specific barriers have a greater impact in determining firm’s possibilities to be engaged in cross-border service trade – external barriers played a smaller role. What might explain these results is that first of all, the study has full focus on service firms of smaller size and internal barriers tend to be particularly effective to SMEs as their resources, skills and capabilities are often limited, which limits internationalization possibilities. Second, the results may indicate that EU’s internal market and the free trade concept function quite well from service firms’ perspective, and the low service movement rate may be rather caused by firm’s own competences and resource-related difficulties than directly by flaws in the market. The results complete earlier literature and provide new and more detailed knowledge of barriers to cross-border service trade in the context of Europe. They also indicate that service internationalization should be observed separately from internationalization of traditional manufacturing firms due to unique service-specific characteristics. The findings of this study are particularly beneficial for small or medium sized service firm managers as it provides knowledge of delivering services across borders in Europe and of barriers that relate to that process.

An Electrophysiological Investigation into the Role of Cognitive Control in the Attentional Blink

Accuracy at reporting a second-target (T2) is reduced if it is presented within approximately 500 ms of the first target (T1) – an attentional blink (AB). Early models explained the AB in terms of attentional limitations creating a processing bottleneck such that T2 processing would be impaired while T1 processing was ongoing. Theoretical models of the AB have more recently been expanded to include the role of cognitive control. In this dissertation I propose that cognitive control, defined as the optimization of information processing in order to achieve goals, is maladapted to the dual-task conditions of the AB task in that cognitive control optimizes the T1 goal, due to its temporal proximity, at the cost of T2. I start with the concept that the role of cognitive control is to serve goals, and that how goals are conceived of and the degree of motivation associated with those goals will determine whether cognitive control will create the condition that cause the AB. This leads to the hypothesis that electrophysiological measures of cognitive control and the degree of attentional investment resulting from cognitive control modulate the AB and explain individual differences in the AB. In a series of four studies feedback-related N2 amplitude, (reflecting individual differences in the strength of cognitive control), and event-related and resting alpha frequency oscillatory activity (reflecting degree of attentional investment), are used to explain both intra- and inter-individual variability in performance on the AB task. Results supported the hypothesis that stronger cognitive control and greater attentional investment are associated with larger AB magnitudes. Attentional investment, as measured by alpha frequency oscillations, and cognitive control, as measured by the feedback-related N2, did not relate to each other as hypothesized. It is proposed that instead of a measure of attentional investment alone, alpha frequency oscillatory activity actually reflects control over information processing over time, in other words the timing of attention. With this conceptualization, various aspects of cognitive control, either related to the management of goals (feedback-related N2) or the management of attention over time to meet goals, explain variability in the AB.

Validité de construit d’un test d’évaluation de la stabilité lombo-pelvienne, le soulèvement actif de la jambe tendue (SAJT) version objective

Introduction : L’évaluation clinique du contrôle neuromusculaire des muscles du tronc est criante en réhabilitation et en entraînement. L’objectif principal de cette étude a été d’évaluer la reproductibilité intra et inter-évaluateur d’un test clinique le soulèvement actif de la jambe tendue (SAJT) chez une population active et saine. Méthode : Chaque sujet (18 joueurs de tennis) a été testé à deux reprises par 2 physiothérapeutes avec le SAJT. Résultats : La reproductibilité intra-évaluateur s’est avérée élevée à très élevée (ICC = 0.81 à 0.93) tandis la reproductibilité inter-évaluateur s’est avérée cliniquement non viable. Conclusion : À notre connaissance, le SAJT est le premier test clinique reproductible évaluant le contrôle neuromusculaire du tronc avec des compensations musculaires et cinétiques chez des sujets actifs et sains. Une formation plus importante des évaluateurs aurait certainement amélioré la reproductibilité inter-évaluateur.

The Money Question and the Good Life

This paper proposes a theory of the good life for use in answering the question how much money the rich should spend on fighting poverty. The paper moves from the abstract to the concrete. To begin with, it investigates various ways to get an answer to the question what is good, and finds itself drawn to objective theories of the good. It then develops, taking Bernard Williams and Martha Nussbaum as its guides, a broad outline of a theory of the good. It holds that something evil happens to people if they do not have a real choice from a reasonable number of projects that realize most of their key capacities to a certain degree, and in connection to this it points to the great importance of money. The paper goes on specifically to consider what criticisms of Nussbaum's version of the capability approach are implied in this outline of a theory of the good. Next, it gets more specific and asks how much money the rich can give -and how they can be restricted in spending their money- without suffering any evil. It does three suggestions: the tithe suggestion, the ecological (or footprint) suggestion, and the fair trade suggestion. To conclude, the paper returns to the question how much money the rich should spend on fighting poverty.

Développement d'outils de surveillance biologique pour l'évaluation des risques à la santé des travailleurs en arboriculture et en viticulture exposés aux fongicides

De nombreux travailleurs utilisent le captan et le folpet comme fongicides en agriculture, mais leur exposition n’est pas toujours mesurée de manière spécifique et précise. La surveillance biologique est un excellent outil à cet effet puisqu’elle permet de quantifier l’exposition réelle. Toutefois, la majorité des connaissances toxicologiques pour ces fongicides proviennent d’études sur les animaux, et les données chez l’humain sont limitées. Le but du présent projet est donc de développer des outils de surveillance biologique pour évaluer l’exposition de travailleurs au captan et au folpet. Dans cette perspective, le projet a été subdivisé en trois parties complémentaires, soit i) de développer des méthodes analytiques spécifiques pour quantifier les biomarqueurs d’intérêt du captan, à savoir le tétrahydrophtalimide (THPI), et du folpet, à savoir le phtalimide (PI) et l’acide phtalique, dans le plasma et l’urine; ii) de déterminer la toxicocinétique des deux fongicides en exposant des volontaires de façon aigüe à de faibles doses de captan ou de folpet par voie orale et cutanée dans des conditions semi-contrôlées et en quantifiant les biomarqueurs dans chacune des deux matrices, excepté l’acide phtalique qui a été mesuré seulement dans l’urine; iii) de valider les biomarqueurs d’exposition sélectionnés et d’évaluer l’exposition réelle des travailleurs et les voies prédominantes d’exposition au captan et au folpet en collectant des données biologiques chez des travailleurs en arboriculture et en viticulture lors d’activités de traitement et d’effeuillage pendant sept jours consécutifs. Selon ces travaux, le THPI et le PI sont deux biomarqueurs valides et spécifiques pour quantifier l’exposition au captan et au folpet, respectivement, chez l’humain. En effet, les méthodes développées pour ces deux métabolites sont robustes avec des limites de détection plus sensibles que celles rapportées dans la littérature, un taux de recouvrement de 90% pour le THPI et de 75% pour le PI, une très bonne linéarité (R2>0,99) et une bonne stabilité avec des variations intra- et inter-journalières faibles (RSD<15%). Elles ont permis de déterminer les profils cinétiques des deux métabolites chez les volontaires et chez les travailleurs. Ces derniers indiquent d’ailleurs une élimination rapide, avec une demi-vie d’élimination dans l’urine de 11,7 h et 18,7 h pour le THPI et de 27,3 h et 28,8 h pour le PI, respectivement après une absorption par voie orale et cutanée, ainsi qu’une faible absorption cutanée lorsque les valeurs sont comparées pour les deux voies d’exposition. Des profils parallèles sont aussi observés entre le PI et l’acide phtalique pour les volontaires et les agriculteurs, mais le folpet se retrouve davantage métabolisé sous forme d’acide phtalique que de PI. Quant à l’étude des agriculteurs, elle montre que la voie principale d’exposition de ces travailleurs est la voie cutanée. Il est aussi souligné qu’il est important 1) de favoriser les collectes d’urines complètes sur 24 h au urines ponctuelles, 2) de mesurer plusieurs métabolites, et 3) d’associer les données de surveillance biologique à la toxicocinétique. Ainsi, les connaissances acquises par cette étude peuvent s’appliquer à d’autres fongicides, voire d’autres substances.

Efficacité de deux méthodes d'enseignement d'hygiène orale chez les patients atteints de maladies rénales

La maladie rénale peut se manifester avec différents types de pathologies buccales pouvant augmenter les risques de bactériémie. Bien que l’endocardite infectieuse soit une condition rare chez les patients atteints de maladie rénale, elle peut toutefois être retrouvée suite à des infections nosocomiales. Dans le passé, une antibiothérapie prophylactique était prescrite aux patients hémodialysés pour les protéger de l’endocardite infectieuse et de l’infection de l’accès d’hémodialyse. Aujourd’hui, cette recommandation est révolue. Afin de contrer les risques de bactériémie transitoire, une attention particulière doit être apportée aux soins d’hygiène orale à la maison. Le but de l’étude est d’évaluer l’efficacité de deux méthodes d’enseignement d’hygiène orale chez les patients atteints de maladie rénale. Objectifs de recherche Les trois objectifs de recherche sont a) d’évaluer les connaissances des parents de patients atteints de maladies rénales sur l’endocardite infectieuse et le lien avec la santé buccodentaire; b) d’évaluer la perception des parents par rapport à la santé buccodentaire de leur enfant et leurs habitudes d’hygiène orale; et c) de comparer l’influence de deux méthodes d’hygiène orale sur l’indice de plaque chez les enfants atteints de maladies rénales. Hypothèses Les deux hypothèses de recherche sont que a) les parents d’enfants atteints de maladies rénales connaissent et adhèrent aux recommandations émises par l’American Heart Association; et que b) l’amélioration de l’indice de plaque chez les patients atteints de maladies rénales est plus grande pour le groupe recevant des instructions par le matériel audiovisuel par rapport à ceux qui les reçoivent par le néphrologue. Méthodologie Suite à l’obtention d’un certificat d’éthique à la recherche du Centre Hospitalier Universitaire Sainte-Justine, 37 des 38 sujets recrutés âgés entre 6 et 16 ans (19 filles et 18 garçons) ont participé à cette étude transversale. Suite à la signature d’un consentement éclairé, les sujets sont assignés par randomisation à l’un des deux groupes d’instructions d’hygiène orale, soit celui sans instructions spécifiques (groupe 1) ou par matériel audiovisuel (groupe 2). Un questionnaire portant sur les connaissances des parents en rapport avec la santé buccodentaire est remis aux parents. Un indice de plaque initial est noté avant l’application des instructions d’hygiène orale reçues. Un indice de plaque final mis en évidence à l’aide de pastilles révélatrices est documenté avec des photographies intra-orales et mesuré par deux observateurs, testés pour la fiabilité intra et inter-observateurs. Résultats Les analyses statistiques ne démontrent aucune différence significative entre les deux groupes d’instructions d’hygiène orale. Les variables à l’étude (âge, sexe, suivi dentaire, fréquence des soins à la maison, connaissances et motivation) ne montrent aucune influence significative sur la qualité de l’hygiène orale des sujets. Seul l’indice de plaque initial est inversement relié à la perception des parents face à la santé buccodentaire de leur enfant : plus le relevé de plaque est bas, plus la santé buccodentaire est perçue comme bonne. Conclusion Selon les résultats de notre étude, il n’existe pas de différence statistiquement significative entre les deux méthodes d’instructions d’hygiène orale. Néanmoins, les deux techniques permettent de diminuer significativement l’indice de plaque chez les enfants atteints de maladies rénales et de conscientiser cette population à l’importance du maintien d’une bonne santé buccodentaire.