The slippery slope - Critical perspectives on in vitro research methodologies

Objectives. This paper attempts to provide critical perspectives on common in vitro research methodologies, including shear bond testing, wear testing, and load-to-failure tests. Origins of interest in high-quality laboratory data is reviewed, in vitro data is categorized into property and simulation protocols, and two approaches are suggested for establishing clinical validity. It is hoped that these insights will encourage further progress toward development of in vitro tests that are validated against clinical performance and/or by producing clinically validated failure or damage mechanisms.Materials and methods. Published shear and tensile bond data (macro and micro) is examined in light of published finite element analyses (FEA). This data is subjected to a Weibull scaling analysis to ascertain whether scaling is consistent with failure from the bonded interface or not. Wear tests results are presented in light of the damage mechanism(s) operating. Quantitative wear data is re-examined as being dependent upon contact pressure. Load-to-failure test results are re-analyzed by calculating contact stresses at failure for 119 tests from 54 publications over more than 25 years.Results. FEA analyses and reported failure modes (adhesive, mixed, cohesive) are consistent with failure not involving interfacial "shear stresses" as calculated in published work. Weibull scaling clearly suggests failure involving external surfaces of specimens, not interfacial origins. Contact stresses (pressures) are clearly an important variable in wear testing and are not well-controlled in published work. Load-to-failure tests create damage not seen clinically due to excessively high contact stresses. Most contact stresses in the 119 tests examined were calculated to be between 1000 MPa and 5000 MPa, whereas clinical contact stresses at wear facets have been measured not to exceed 40 MPa.Conclusions. Our community can do a much better job of designing in vitro tests that more closely simulate clinical conditions, especially when contact is involved. Journals are encouraged to thoughtfully consider a ban on publishing papers using bond tests and load-to-failure methods that are seriously flawed and have no clinical relevance. (C) 2011 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Culture, politics and identity: critical readings on gender in southeast Asia

Indian Journal of Gender Studies October 2012 vol. 19 no. 3 437-467

Modularity in Health and Social Services: Perspectives on Organization and Management

Organizations that provide health and social services operate in a complex and constantly changing environment. Changes occur, for example, in ageing, technology and biotechnology, and customers’ expectations, as well as the global economic situation. Organizations typically aim to adapt the changes by introducing new organizational structures and managerial practices, such as process and lean management. Only recently has there been an interest in evaluating whether organizations providing health and social services could apply modularity in order to respond to some of the changes. The concept of modularity originates from manufacturing, but is applied in many other disciplines, such as information technology and logistics. However, thus far, the literature concerning modularity in health and social services is scarce. Therefore the purpose of this thesis is to increase understanding concerning modularity and the possibilities to apply modularity in the health and social services context. In addition, the purpose is to shed light on the viewpoints that are worth taking into account when considering the application of modularity in the health and social services context. The aim of the thesis is to analyze the way in which the modular structures are applied in the health and social services context and to analyze what advantages and possible barriers, as well as managerial concerns, might occur if modularity is applied in the health and social services context. The thesis is conducted by using multiple methods in order to provide a broad aspect to the topic. A systematic literature review provided solid ground for pre-understanding the topic and supported the formulation of the research questions. Theoretical reasoning provided a general overview of the special characteristics of the health and social services context and their effect on application of modularity. Empirical studies concentrated on managerial concerns of modularity particularly from the perspective of health and social services for the elderly. Results of the thesis reveal that structures in products, services, processes, and organizations are rather modular in health and social services. They can be decomposed in small independent units, while the challenges seem to occur especially in the compatibility of the services. It seems that health and social services managers have recognized this problem and they are increasingly paying attention to this challenge in order to enhance the flexible compatibility of services. Advantages and possible barriers of modularity are explored in this thesis, and from the theoretical perspective it could be argued that modularity seems to be beneficial in the context of health and social services. In fact, it has the potential to alleviate several of the challenges that the health and social services context is confronting. For example, modular structures could support organizations in their challenging task to respond to customers’ increasing demand for heterogeneous services. However, special characteristics of the health and social services context create barriers and provide significant challenges in application of modularity. For example, asymmetry of information, negative externalities, uncertainty of demand, and rigid regulation prevent managers from extensively drawing benefits from modularity. Results also reveal that modularity has managerial implications in health and social service. Modularity has the potential to promote and support new service development and outsourcing. Results also provide insights into network management and increases managerial understanding of different network management strategies. Standardization in health and social services is extensive due to legislation and recommendations. Modularity provides alternative paths to take an advantage of standardization while still ensuring the quality of the services. Based on this thesis, it can be concluded, both from a theoretical perspective and from empirical results concerning modularity in health and social services, that modularity might fit well and be beneficial. However, the special characteristics of the health and social services context prevent some of the benefits of modularity and complicate its application. This thesis contributes to the academic literature on the organization and management of health and social services by describing modularity as an alternative way for organizing and managing health and social services. In addition, it contributes to the literature of modularity by exploring the applicability of modularity in the context of health and social services. It also provides practical contribution to health and social services managers by evaluating the pros and cons of modularity when applied to health and social services.

Plenary Lecture 2: Milk and dairy produce and CVD: new perspectives on dairy and cardiovascular health

Cardiovascular diseases (CVD) are the leading cause of mortality and morbidity worldwide. One of the key dietary recommendations for CVD prevention is reduction of saturated fat intake. Yet despite milk and dairy foods contributing on average 27 % of saturated fat intake in the UK diet, evidence from prospective cohort studies does not support a detrimental effect of milk and dairy foods on risk of CVD. This paper provides a brief overview of the role of milk and dairy products in the diets of UK adults, and will summarise the evidence in relation to the effects of milk and dairy consumption on CVD risk factors and mortality. The majority of prospective studies and meta-analyses examining the relationship between milk and dairy product consumption and risk of CVD show that milk and dairy products, excluding butter, are not associated with detrimental effects on CVD mortality or risk biomarkers, that include serum LDL cholesterol. In addition, there is increasing evidence that milk and dairy products are associated with lower blood pressure and arterial stiffness. These apparent benefits of milk and dairy foods have been attributed to their unique nutritional composition, and suggest that the elimination of milk and dairy may not be the optimum strategy for CVD risk reduction.