A randomized follow-up study of the general health and quality of life of an elderly edentulous population wearing either mandibular two-implant overdentures or conventional dentures

L’augmentation de la population âgée dans la société indique que les systèmes de soins de la santé font face à de nouveaux défis. Les hauts niveaux d’incapacité qui en résultent peuvent être réduits par les nouvelles technologies, la promotion de la santé ainsi que des stratégies de prévention. Les écrits scientifiques récents soulignent la supériorité des prothèses dentaires implanto-portées par rapport aux prothèses conventionnelles en termes de satisfaction et de qualité de la vie des patients. Cependant, il n'est toujours pas clair si ces avantages ont des effets positifs à long terme sur la santé orale et générale ainsi que sur la qualité de vie des populations âgées. Objectifs, Hypothèses : Notre but était de mesurer l’impact des prothèses mandibulaires retenues par 2 implants sur la qualité de vie associée à la santé bucco-dentaire et générale ainsi que sur la santé orale et la qualité du sommeil des aînés édentés. Nous avons évalué les hypothèses nulles suivantes : il n'y a aucune différence entre les individus portants des prothèses mandibulaires retenues par 2 implants (IODs) et ceux qui portent des prothèses conventionnelles (CDs), par rapport à la qualité de vie reliée à la santé bucco-dentaire et générale, la santé orale et la qualité du sommeil, un an après avoir reçu leurs nouvelles prothèses. Méthodes : Dans cette étude randomisée contrôlée, 255 aînés ont reçu au hasard IODs ou les CDs, les deux types de prothèses étant opposés à des prothèses maxillaires conventionnelles. La qualité de la vie reliée à la santé bucco-dentaire (OHRQoL) et la santé générale subjective ont été mesurées avec les questionnaires Oral Health Impact Profile (OHIP-20) et Short Form-36 (SF-36) en condition pré-traitement et après un an. La qualité du sommeil et la somnolence diurne ont été mesurées à l’aide du questionnaire Qualité de Sommeil de Pittsburg et de l'Échelle de Somnolence Epworth. La santé orale a été évaluée par un examen clinique. Les variables indépendantes étaient le sens de cohérence et le type de prosthèse, ainsi que des variables socio-démographiques. En utilisant des analyses statistiques bi et multi-factorielles, des comparaisons à l’intérieur d’un même groupe et entre deux groupes ont été effectuées. Résultats : Les différences pré et post traitement pour les cotes OHIP étaient significativement plus grandes pour le groupe IOD que le groupe CD (p<0.05). Le type de traitement et la cote pré-traitement étaient des facteurs significatifs à OHRQoL (p < 0.0001). Dans le groupe CD, il y avait une diminution significative par rapport aux cotes de «Physical Component Scores (PCS)», le fonctionnement physique, le rôle physique et la douleur physique entre les données pré-traitement et un an après le traitement, ce qui indique une diminution au niveau de la santé générale subjective. Dans le groupe IOD, une diminution statistiquement non significative a été remarquée par rapport à toutes les cotes des sous-échelles de SF-36, sauf pour la douleur physique. Le modèle final de régression a démontré qu’après ajustement pour les variables âge, sexe, statut marital et type de traitement, la cote totale finale d’OHIP et les données de bases de PCS prédisaient la cote finale de PCS (p < 0.0001). Aucune corrélation significative entre sens de cohérence et OHRQoL n'a été détectée (r =-0.1; p > 0.05). Les aînés porteurs des prothèses conventionnelles avaient presque 5 fois plus de chance d’avoir une stomatite prothétique que ceux portant des prothèses mandibulaires hybrides retenues par 2 implants (p < 0.0001). Les aînés ayant subjectivement une mauvaise santé générale avaient une qualité de sommeil moins bonne que ceux avec une meilleure santé générale subjective (p < 0.05). Les personnes qui avaient une OHRQoL moins bonne étaient presque 4 fois plus somnolentes pendant le jour que celles avec une meilleure OHRQoL (p=0.003, χ2; OR =3.8 CI 1.5 to 9.8). L'analyse de régression a montré que la santé générale subjective et OHRQoL prévoient la qualité du sommeil (p=0.022 et p=0.001, respectivement) et la somnolence diurne (p=0.017 et p=0.005, respectivement). Conclusions: Les résultats de cette étude suggèrent que, chez les aînés édentés, des prothèses mandibulaires hybrides retenues par deux implants amènent une amélioration significative de la qualité de vie reliée à la santé bucco-dentaire et maintiennent la sensation d’une meilleure santé physique. Des prothèses hybrides implanto-portées peuvent contribuer à la santé orale en réduisant les traumatismes infligés à la muqueuse orale et en contrôlant la stomatite prothétique. Les aînés édentés dont le niveau de qualité de vie reliée à la santé bucco-dentaire est bas, peuvent aussi avoir des troubles de qualité du sommeil.

Modelling software quality : a multidimensional approach

Les sociétés modernes dépendent de plus en plus sur les systèmes informatiques et ainsi, il y a de plus en plus de pression sur les équipes de développement pour produire des logiciels de bonne qualité. Plusieurs compagnies utilisent des modèles de qualité, des suites de programmes qui analysent et évaluent la qualité d'autres programmes, mais la construction de modèles de qualité est difficile parce qu'il existe plusieurs questions qui n'ont pas été répondues dans la littérature. Nous avons étudié les pratiques de modélisation de la qualité auprès d'une grande entreprise et avons identifié les trois dimensions où une recherche additionnelle est désirable : Le support de la subjectivité de la qualité, les techniques pour faire le suivi de la qualité lors de l'évolution des logiciels, et la composition de la qualité entre différents niveaux d'abstraction. Concernant la subjectivité, nous avons proposé l'utilisation de modèles bayésiens parce qu'ils sont capables de traiter des données ambiguës. Nous avons appliqué nos modèles au problème de la détection des défauts de conception. Dans une étude de deux logiciels libres, nous avons trouvé que notre approche est supérieure aux techniques décrites dans l'état de l'art, qui sont basées sur des règles. Pour supporter l'évolution des logiciels, nous avons considéré que les scores produits par un modèle de qualité sont des signaux qui peuvent être analysés en utilisant des techniques d'exploration de données pour identifier des patrons d'évolution de la qualité. Nous avons étudié comment les défauts de conception apparaissent et disparaissent des logiciels. Un logiciel est typiquement conçu comme une hiérarchie de composants, mais les modèles de qualité ne tiennent pas compte de cette organisation. Dans la dernière partie de la dissertation, nous présentons un modèle de qualité à deux niveaux. Ces modèles ont trois parties: un modèle au niveau du composant, un modèle qui évalue l'importance de chacun des composants, et un autre qui évalue la qualité d'un composé en combinant la qualité de ses composants. L'approche a été testée sur la prédiction de classes à fort changement à partir de la qualité des méthodes. Nous avons trouvé que nos modèles à deux niveaux permettent une meilleure identification des classes à fort changement. Pour terminer, nous avons appliqué nos modèles à deux niveaux pour l'évaluation de la navigabilité des sites web à partir de la qualité des pages. Nos modèles étaient capables de distinguer entre des sites de très bonne qualité et des sites choisis aléatoirement. Au cours de la dissertation, nous présentons non seulement des problèmes théoriques et leurs solutions, mais nous avons également mené des expériences pour démontrer les avantages et les limitations de nos solutions. Nos résultats indiquent qu'on peut espérer améliorer l'état de l'art dans les trois dimensions présentées. En particulier, notre travail sur la composition de la qualité et la modélisation de l'importance est le premier à cibler ce problème. Nous croyons que nos modèles à deux niveaux sont un point de départ intéressant pour des travaux de recherche plus approfondis.

A new method for evaluating regional air quality forecasts

A Kriging interpolation method is combined with an object-based evaluation measure to assess the ability of the UK Met Office's dispersion and weather prediction models to predict the evolution of a plume of tracer as it was transported across Europe. The object-based evaluation method, SAL, considers aspects of the Structure, Amplitude and Location of the pollutant field. The SAL method is able to quantify errors in the predicted size and shape of the pollutant plume, through the structure component, the over- or under-prediction of the pollutant concentrations, through the amplitude component, and the position of the pollutant plume, through the location component. The quantitative results of the SAL evaluation are similar for both models and close to a subjective visual inspection of the predictions. A negative structure component for both models, throughout the entire 60 hour plume dispersion simulation, indicates that the modelled plumes are too small and/or too peaked compared to the observed plume at all times. The amplitude component for both models is strongly positive at the start of the simulation, indicating that surface concentrations are over-predicted by both models for the first 24 hours, but modelled concentrations are within a factor of 2 of the observations at later times. Finally, for both models, the location component is small for the first 48 hours after the start of the tracer release, indicating that the modelled plumes are situated close to the observed plume early on in the simulation, but this plume location error grows at later times. The SAL methodology has also been used to identify differences in the transport of pollution in the dispersion and weather prediction models. The convection scheme in the weather prediction model is found to transport more pollution vertically out of the boundary layer into the free troposphere than the dispersion model convection scheme resulting in lower pollutant concentrations near the surface and hence a better forecast for this case study.

Customer experience quality: an exploration in business and consumer contexts using repertory grid technique

This study proposes a conceptual model for customer experience quality and its impact on customer relationship outcomes. Customer experience is conceptualized as the customer’s subjective response to the holistic direct and indirect encounter with the firm, and customer experience quality as its perceived excellence or superiority. Using the repertory grid technique in 40 interviews in B2B and B2C contexts, the authors find that customer experience quality is judged with respect to its contribution to value-in-use, and hence propose that value-in-use mediates between experience quality and relationship outcomes. Experience quality includes evaluations not just of the firm’s products and services but also of peer-to-peer and complementary supplier encounters. In assessing experience quality in B2B contexts, customers place a greater emphasis on firm practices that focus on understanding and delivering value-in-use than is generally the case in B2C contexts. Implications for practitioners’ customer insight processes and future research directions are suggested.

Subjective well-being and relative poverty in rural Bangladesh

This paper revisits the debate over the importance of absolute vs. relative income as a correlate of subjective well-being using data from Bangladesh, one of the poorest countries in the world with high levels of corruption and poor governance. We do so by combining household data with population census and village survey records. Our results show that conditional on own household income, respondents report higher satisfaction levels when they experience an increase in their income over the past years. More importantly, individuals who report their income to be lower than their neighbours in the village also report less satisfaction with life. At the same time, our evidence suggests that relative wealth effect is stronger for the rich. Similarly, in villages with higher inequality, individuals report less satisfaction with life. However, when compared to the effect of absolute income, these effects (i.e. relative income and local inequality) are modest. Amongst other factors, we study the influence of institutional quality. Institutional quality, measured in terms of confidence in police, matters for well-being: it enters with a positive and significant coefficient in the well-being function.

Meat quality of swine supplemented with ractopamine under commercial conditions in Brazil

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Development of a water quality index using a fuzzy logic: A case study for the sorocaba river

Due to growing urbanization and industrialization, the environment is suffering from pollution of rivers, degradation of soils and deteriorated air quality. Quality indices appear to be useful to evaluate the conditions of these media. The aim of this study was the development of a water quality index using a fuzzy inference system, since such an approach has proved advantageous in addressing problems that are subjective by nature or for which the data are uncertain. The methodology employed was based on this inference system, and considered the nine water quality parameters employed by CETESB (Companhia de Tecnologia de Saneamento Ambiental, São Paulo, Brazil) to evaluate water quality. After assessment of the data using the index, a comparison was made with the WQI (Water Quality Index), which is used for the monitoring of various water bodies, including in the study region. The results obtained using the index developed on the basis of fuzzy inference were found to be more useful than those derived from the method currently used by CETESB, since losses and/or omissions concerning individual parameters were minimized. © 2010 IEEE.

Image quality evaluation of chest for computed radiography

The daily-to-day of medical practice is marked by a constant search for an accurate diagnosis and therapeutic assessment. For this purpose the doctor serves up a wide variety of imaging techniques, however, the methods using ionizing radiation still the most widely used because it is considered cheaper and above all very efficient when used with control and quality. The optimization of the risk-benefit ratio is considered a major breakthrough in relation to conventional radiology, though this is not the reality of computing and digital radiology, where Brazil has not established standards and protocols for this purpose. This work aims to optimize computational chest radiographs (anterior-posterior projection-AP). To achieve this objective were used a homogeneous phantoms that simulate the characteristics of absorption and scattering of radiation close to the chest of a patient standard. Another factor studied was the subjective evaluation of image quality, carried out by visual grading assessment (VGA) by specialists in radiology, using an anthropomorphic phantom to identify the best image for a particular pathology (fracture or pneumonia). Quantifying the corresponding images indicated by the radiologist was performed from the quantification of physical parameters (Detective Quantum Efficiency - DQE, Modulation Transfer Function - MTF and Noise Power Spectrum - NPS) using the software MatLab®. © 2013 Springer-Verlag.

Life quality assessment of patients after phacoemulsification or extracapsular cataract extraction

Métodos: O trabalho foi realizado no Serviço de Oftalmologia do Hospital Universitário Bettina Ferro de Souza, Belém, Pará, Brasil. O desenho experimental consistiu em séries de casos comparados. O estudo incluiu 60 indivíduos com catarata. Metade dos pacientes foi submetida à extração de catarata extracapsular convencional (ECEE) e a outra metade à extração de catarata por facoemulsificação (PHACO). Os pacientes foram entrevistados usando-se o questionário Visual Function 14 (VF-14) para determinar a qualidade de vida antes e 30 dias depois da cirurgia. Os resultados do exame oftalmológico foram registrados no arquivo de cada paciente e disponibilizados ao longo do trabalho. Foram usados análise de variância simples e comparação post-hoc com teste de Tukey e teste dos sinais para a análise estatística dos resultados. Resultados: O índice de satisfação médio VF-14 foi 38,0 e 89,4 antes e após a cirurgia, respectivamente, para o grupo ECEE, sendo 47,0 e 94,1 para o grupo PHACO. A melhora na qualidade de vida após a cirurgia foi significativa em ambos os grupos de pacientes (p<0,0001), tendo sido semelhante em ambos os grupos. Conclusão: A melhora observada na qualidade de vida avaliada foi significativa e diretamente relacionada à satisfação dos pacientes com os resultados da cirurgia, a qual também foi significativa (p<0,0001). A satisfação e a qualidade de vida são fatores individuais. Consequentemente, as respostas dos pacientes relativas à melhoria em cada atividade são subjetivas e dependem unicamente da percepção individual.

A method using artificial neural networks to morphologically assess mouse blastocyst quality

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Physical education and quality of life: reflections and perspectives

The study of the quality of life of individuals has become a prominent issue for contemporary society. However, research involving quality of life should consider that this is a complex issue that involves objective and subjective aspects, living conditions, lifestyles and multidimensional factors. There is a widespread idea in society that physical activity, exercise, sports and related activities can have a positive impact on improving the quality of life of the population. However, in several studies, this relationship is examined from the biological point of view, which considers only health indicators. Such practices are being studied in the area of Physical Education in various perspectives, such as biological, psychological, social, and cultural. Therefore, Physical Education should seek to produce knowledge that meets the scientific principles, and look for evidence that effectively clarifies the dynamics of this relationship. In this sense, methodological rigor, particularly the conceptual definition, is essential for a better understanding of the results and of which generalizations are actually likely to e proved. In addition, it is necessary to identify the possibilities and limitations of quantitative evaluations, qualitative evaluations and possible combinations.

Positive Affection Measurement: Subjective Well-Being in Married People

The study analyzed the correlations among the different factors of subjective well-being (SWB) using a sample of 106 married people with an average of 16.11 years of marriage. The following instruments were used: Sociodemographic Questionnaire, Socioeconomic Questionnaire, and Subjective Well-being Scale (SWBS). Data analyses were conducted using the Software R and a multivariate model to understand the correlations among the factors of the SWBS. All factors of the SWBS were significantly inter-correlated, which confirm the results of the scale validation study. Future studies are necessary to evaluate the SWB in couples (dyads), which can help to understand whether this concept is influenced by the spouse or only by the marital status.

Quality Metric to Assess Video Streaming Service over TCP considering Temporal Location of Pauses

There is a wide range of video services over complex transmission networks, and in some cases end users fail to receive an acceptable quality level. In this paper, the different factors that degrade users' quality of experience (QoE) in video streaming service that use TCP as transmission protocol are studied. In this specific service, impairment factors are: number of pauses, their duration and temporal location. In order to measure the effect that each temporal segment has in the overall video quality, subjective tests. Because current subjective test methodologies are not adequate to assess video streaming over TCP, some recommendations are provided here. At the application layer, a customized player is used to evaluate the behavior of player buffer, and consequently, the end user QoE. Video subjective test results demonstrate that there is a close correlation between application parameters and subjective scores. Based on this fact, a new metrics named VsQM is defined, which considers the importance of temporal location of pauses to assess the user QoE of video streaming service. A useful application scenario is also presented, in which the metrics proposed herein is used to improve video services(1).

Endoscopic Laser Thyroarytenoid Myoneurectomy in Patients with Adductor Spasmodic Dysphonia: A Pilot Study on Long-Term Outcome on Voice Quality

Objectives. Adductor spasmodic dysphonia (ADSD) is a focal laryngeal dystonia, which compromises greatly the quality of life of the patients involved. It is a severe vocal disorder characterized by spasms of laryngeal muscles during speech, producing phonatory breaks, forced, strained and strangled voice. Its symptoms result from involuntary and intermittent contractions of thyroarytenoid muscle during speech, which causes vocal fold to strain, pressing each vocal fold against the other and increasing glottic resistance. Botulinum toxin injection remains the gold-standard treatment. However, as injections should be repeated periodically leading to voice quality instability, a more definitive procedure would be desirable. In this pilot study we report the long-term vocal quality results of endoscopic laser thyroarytenoid myoneurectomy. Study Design. Prospective study. Methods. Surgery was performed in 15 patients (11 females and four males), aged between 29 and 73 years, diagnosed with ADSD. Voice Handicap Index (VHI) was obtained before and after surgery (median 31 months postoperatively). Results. A significant improvement in VHI was observed after surgery, as compared with baseline values (P = 0.001). The median and interquartile range for preoperative VHI was 99 and 13, respectively and 24 and 42, for postoperative VHI. Subjective improvement of voice as assessed by the patients showed median improvement of 80%. Conclusions. Because long-term follow-up showed significant improvement of voice quality, this innovative surgical technique seems a satisfactory alternative treatment of ADSD patients who seek a definite improvement of their condition.

Selection of Top 10 Quality Indicators for Nutrition Therapy

Background: The identification of useful quality indicators for nutrition therapy (QINTs) is of great interest and a challenge. This study attempted to identify the 10 QINTs that best suit the practice of quality control in nutrition therapy (NT) by evaluating the opinion of experts in NT with the use of psychometric techniques and statistical tools. Methods: Thirty-six QINTs available for clinical application in Brazil were assessed in 2 distinct phases. In phase 1, 26 nutrition experts ranked QINTs by scoring 4 attributes (utility, simplicity, objectivity, low cost) to assess each QINT on a 5-point Likert scale. The top 10 QINTs were identified from the 10 best scores obtained, and the reliability of expert opinion for each indicator was assessed by Cronbach's alpha. In phase 2, experts provided feedback regarding the selected top 10 QINTs by answering 2 closed questions. Results: The top 10 QINTs, in descending order, are the frequency of nutrition screening of hospitalized patients, diarrhea, involuntary withdrawal of enteral feeding tubes, feeding tube obstruction, fasting longer than 24 hours, glycemic dysfunction, estimated energy expenditure and protein needs, central venous catheter infection, compliance of NT indication, and frequency of application of subjective global assessment. Opinions were consistent among the interviewed experts. During feedback, 96% of experts were satisfied with the top 10 QINTs, and 100% had considered them in accordance with their previous opinion. Conclusion: The top 10 QINTs were identified according to their usefulness in clinical practice by obtaining adequate agreement and representativeness of opinion of nutrition experts. (Nutr Clin Pract. 2012;27:261-267)