Achieving complete health requires a deep understanding of complementary cultural competency sensitivity between physician and patient. This may include but is not limited to access to preventative health care resources, access to health educational resources and access to cultural healing resources, for example, shamans, Ayurvedic physicians, and herbal healers. Advocates of cultural competency emphasize great importance on knowledge of the patients' cultural background; however, the transcendence of this knowledge can be explained further through complementary cultural competency sensitivity. This is when the cultures of the physician and patient complement each other in terms of understanding what is in the patients' best interest in the overall goal of healing and complete health for the patient. The explanation of this concept revolves around the idea that health is not just found within body wellness physically, but also mentally and emotionally. The tragedies of poor health outcomes we face have psychological repercussions with a significant social determinant that bio-medical medication cannot and should not solve. The purpose of research includes theoretical discussions that address questions of: What roles do Evidence Based Results play for Medical Anthropologists? How will having knowledge of socioeconomic status, cultural practices and determinants of environmental insult and structural violence as experienced by the individual patient influence the facilitation of the process of creating a positive health outcome for the patient? How can "End of Life" issues be better addressed? How does language influence health? Does a positive dialogue between health professionals and patients contribute to better health outcomes? Research will emphasize the idea that Ethnomedicine (traditional medicine) and Western Bio-medicine complement each other within the model of complementary cultural competency sensitivity. The Holistic Complementary Structure of Western Bio-medicine and Traditional Healing is a multifaceted mean by which the manifestations of complete and positive health results occur. The methods of research used in the research include ethnographic interview content discussions, primary and secondary literature sources, and research of bio-statistical data. The interview discussions consist of dialogue with Medical Anthropologists, a Nurse Practitioner, a Global Health Studies Ph.D. professor and an Africana Studies Ph.D. professor. In order to prove the hypothesis, explanations through examples of Ethnomedicine (traditional medicine) and Western Bio-medicine working together, show how the combination of the two modalities along with the factors of complementary cultural competency sensitivity between patient and physician contribute to positive health outcomes.

Introduction: La stomatite prothétique est une condition inflammatoire chronique de la muqueuse buccale recouverte par une prothèse. Cette maladie est considérée comme la lésion buccale la plus fréquente chez les porteurs de prothèses amovibles. Des études récentes sur l'étiologie de la stomatite prothétique suggèrent que des traitements basés sur la réduction de l'inflammation seraient efficaces dans le traitement de cette maladie. Objectifs: Évaluer l'efficacité du brossage du palais dans le traitement de la stomatite prothétique. Méthodes: Quarante-huit participants (âge moyen : 66,0 ± 11,2 ans) avec un diagnostic de stomatite prothétique, ont été sélectionnés à partir d’un examen préalable de 143 individus, afin de participer à cet essai clinique de phase I à deux centres, réalisé selon un devis de type pré-test/post-test à un seul groupe. L'intervention a consisté en un brossage du palais avec une brosse manuelle après chaque repas et avant le coucher. Des examens cliniques et microbiologiques ont été effectués avant le traitement, et à 1 mois et 3 mois de suivi. Des données supplémentaires ont été obtenues par l'utilisation d'un questionnaire validé. Les résultats primaires et secondaires étaient, respectivement, la rémission de stomatite prothétique et la diminution du nombre de colonies de Candida. Des tests statistiques descriptifs et non paramétriques ont été menés pour analyser les données. Résultats: À 3 mois de suivi, 10,4 % des participants ont été guéris et 70,8 % ont eu une amélioration clinique de la stomatite prothétique grâce au brossage du palais. Une réduction statistiquement significative de la surface et de l’intensité de l’inflammation après 3 mois de brossage du palais a été démontrée (p < 0,0001). L’ampleur de l’effet a varié d’un effet modéré à important (0,34 à 0,54) selon la classification utilisée pour le diagnostique de la stomatite prothétique. De plus, le nombre de colonies de Candida, recueillies par sonication des prothèses et par échantillonnage du palais, a diminué de manière statistiquement significative après 3 mois de brossage (p ≤ 0,05). Conclusion: Les résultats de cette étude suggèrent que le brossage du palais est efficace comme traitement de la stomatite prothétique. / Introduction: Denture-related erythematous stomatitis (denture stomatitis) is a chronic inflammation of the oral mucosa covered by a removable prosthesis. This disease is considered the most prevalent mucosal lesion associated with prosthesis use. Recent research on the etiology of denture stomatitis suggests that treatments based on the reduction of the inflammation are effective in the management of this disease. Objectives: To assess the efficacy of palatal brushing in the treatment of denture stomatitis. Methods: After screening 143 individuals with a potential diagnosis of denture stomatitis, 48 (mean age: 66.0 ± 11.2 years) were enrolled in a phase-I two-center clinical trial with one-group pre-test/post-test design. The intervention of interest was manual palatal brushing after each meal and before bedtime. Clinical and microbiological examinations were performed at baseline, 1 month and 3 months post-intervention. Additional data were obtained by the use of a validated questionnaire. The primary and secondary outcomes were the remission of denture stomatitis and the diminution of Candida Colony-Forming Units (CFUs), respectively. Descriptive and non-parametric statistical tests were conducted to analyze the data. Results: At 3-month follow-up, denture stomatitis was completely cured in 10.4 % of the study participants, and 70.8 % of denture wearers showed improvement in the clinical signs of denture stomatitis. There was a significant reduction in the area and severity of the palatal inflammation at 3-month follow-up (p < 0.0001). The effect size ranged from medium to large (0.34 to 0.54), depending on the classification used for the diagnosis of denture stomatitis. Furthermore, a significant reduction in the number of Candida CFUs isolated from the palatal mucosa and dentures was observed (p ≤ 0.05). Conclusion: The results of this study suggest that palatal brushing is effective in the treatment of denture stomatitis.

The majority of laboratory testing errors originate in the pre-analytical phase. While the causes and frequencies of pre-analytical errors are well characterized, there are few studies investigating the cost of these errors. The objective of this research was to build a model to quantify the cost of pre-analytical errors occurring during inpatient complete blood count (CBC) testing at Sunnybrook Health Sciences Centre (Sunnybrook). The resultant cost model accounts for the costs of materials, resources, and personnel-time consumed in the CBC testing process. In 2011, pre-analytical errors in inpatient CBC testing cost Sunnybrook $43,462, and represented a loss of 775 employee hours due to laboratory test repetition and error-related activities. This cost model represents the minimum cost of a pre-analytical error, as costs extraneous to the laboratory were beyond the study scope. Future studies investigating downstream effects of pre-analytical errors and the costs associated with them should be conducted.

The majority of laboratory testing errors originate in the pre-analytical phase. While the causes and frequencies of pre-analytical errors are well characterized, there are few studies investigating the cost of these errors. The objective of this research was to build a model to quantify the cost of pre-analytical errors occurring during inpatient complete blood count (CBC) testing at Sunnybrook Health Sciences Centre (Sunnybrook). The resultant cost model accounts for the costs of materials, resources, and personnel-time consumed in the CBC testing process. In 2011, pre-analytical errors in inpatient CBC testing cost Sunnybrook $43,462, and represented a loss of 775 employee hours due to laboratory test repetition and error-related activities. This cost model represents the minimum cost of a pre-analytical error, as costs extraneous to the laboratory were beyond the study scope. Future studies investigating downstream effects of pre-analytical errors and the costs associated with them should be conducted.

Le scanner laser aéroporté est une technique d'imagerie très prometteuse, notamment pour l'observation des zones forestières. En particulier, la déclinaison "onde complète", qui consiste à enregistrer l'intégralité du signal lumineux réfléchi par la scène suite à l'émission d'une impulsion laser, permet de sonder les couverts végétaux en profondeur. De nombreux systèmes commerciaux sont disponibles et d'ores et déjà utilisés en particulier en topographie ou en bathymétrie. Mais ces systèmes ne sont pas dédiés à l'observation de la végétation. L'objectif de cette thèse est l'étude de l'intérêt de ces systèmes pour la reconstruction géométrique des modèles numériques de terrain sous couvert végétal, et le développement d'outils qui permettront d'optimiser les performances des systèmes lidar onde complète dans ce but. Dans un premier temps, nous avons développé un modèle physique de lidar onde complète adapté à la simulation de l'observation de scènes de végétation. Le modèle DELiS (n-Dimensional Estimation of Lidar Signals) permet de simuler l'observation de scènes de végétation complexes et réalistes, tout en incluant la prise en compte de l'environnement extérieur (atmosphère, soleil) ainsi que des bruits de mesure. Une fois le modèle DELiS validé par confrontation à des résultats analytiques, nous avons utilisé ses capacités de simulation afin d'étudier l'intérêt du lidar onde complète pour la reconstruction d'un modèle numérique de terrain sous couvert végétal. Dans ce but, nous avons mis en place une méthode originale de traitement et de classification des données lidar onde complète permettant de séparer les échos lidar provenant du sol de ceux provenant de la végétation. Grâce à ces données classifiées, nous pouvons ensuite reconstruire la géométrie du sol et des objets initialement occultés par la végétation. Enfin, nous nous intéresserons à la possibilité de combiner des données aéroportées acquises sous différents points de vue afin d'améliorer les reconstructions. Mis à part le développement d'un outil opérationnel de simulation de la mesure lidar onde complète, qui pourra servir de support à de nombreuses études ainsi qu'au développement et au dimensionnement de nouveaux instruments, nous avons pu démontrer dans cette thèse que le scanner laser aéroporté onde complète pouvait permettre d'obtenir en milieux forestier des reconstructions de la géométrie du terrain à des résolutions sub-métriques et avec une précision de l'ordre de 10 à 20 centimètres. La combinaison des visées multi-angulaire permet, par l'apport d'une quantité importante d'information supplémentaire, d'améliorer encore les reconstructions. Nous montrons cependant que les visées inclinées sont plus sensibles à la présence des troncs et branchages des arbres, éléments qui sont susceptibles d'introduire une erreur importante dans les processus de classification et de reconstruction. Pour cette raison, nous recommandons l'utilisation de la visée nadir pour la reconstruction mono-vue des modèles numériques de terrain, et nous proposons une méthode permettant de choisir de façon optimale les visées inclinées à ajouter pour l'observation détaillée d'une portion plus restreinte de la scène.

Streptococcus equi is the causative agent of strangles, a prevalent and highly contagious disease of horses. Despite the animal suffering and economic burden associated with strangles, little is known about the molecular basis of S. equi virulence. Here we have investigated the contributions of a specific lipoprotein and the general lipoprotein processing pathway to the abilities of S. equi to colonize equine epithelial tissues in vitro and to cause disease in both a mouse model and the natural host in vivo. Colonization of air interface organ cultures after they were inoculated with a mutant strain deficient in the maturase lipoprotein (prtM138-213, with a deletion of nucleotides 138 to 213) was significantly less than that for cultures infected with wild-type S. equi strain 4047 or a mutant strain that was unable to lipidate preprolipoproteins (lgt190-685). Moreover, mucus production was significantly greater in both wild-type-infected and lgt190-685-infected organ cultures. Both mutants were significantly attenuated compared with the wild-type strain in a mouse model of strangles, although 2 of 30 mice infected with the lgt190-685 mutant did still exhibit signs of disease. In contrast, only the prtM138-213 mutant was significantly attenuated in a pony infection study, with 0 of 5 infected ponies exhibiting pathological signs of strangles compared with 4 of 4 infected with the wild-type and 3 of 5 infected with the lgt190-685 mutant. We believe that this is the first study to evaluate the contribution of lipoproteins to the virulence of a gram-positive pathogen in its natural host. These data suggest that the PrtM lipoprotein is a potential vaccine candidate, and further investigation of its activity and its substrate(s) are warranted.

Based on the author's Ph. D. thesis, University of California, Berkeley, 1993. / Includes bibliographical references (p. [73]-78) and index. Also issued online.

Σκοπός της παρούσας διπλωματικής διατριβής είναι η μελέτη και ανάπτυξη ενός νέου αλγοριθμικού πλαισίου Συνεργατικής Διήθησης(CF) για την παραγωγή συστάσεων. Η μέθοδος που προτείνουμε, βασίζεται στην εκμετάλλευση της ιεραρχικής διάρθρωσης του χώρου αντικειμένων και πατά διαισθητικά στην ιδιότητα της ``Σχεδόν Πλήρης Αναλυσιμότητας'' (NCD) η οποία είναι συνυφασμένη με τη δομή της πλειοψηφίας των ιεραρχικών συστημάτων. Η Συνεργατική Διήθηση αποτελεί ίσως την πιο πετυχημένη οικογένεια τεχνικών για την παραγωγή συστάσεων. Η μεγάλη απήχησή της στο διαδίκτυο αλλά και η ευρεία εφαρμογή της σε σημαντικά εμπορικά περιβάλλοντα, έχουν οδηγήσει στη σημαντική ανάπτυξη της θεωρίας την τελευταία δεκαετία, όπου μια ευρεία ποικιλία αλγορίθμων και μεθόδων έχουν προταθεί. Ωστόσο, παρά την πρωτοφανή τους επιτυχία οι CF μέθοδοι παρουσιάζουν κάποιους σημαντικούς περιορισμούς συμπεριλαμβανομένης της επεκτασιμότητας και της αραιότητας των δεδομένων. Τα προβλήματα αυτά επιδρούν αρνητικά στην ποιότητα των παραγόμενων συστάσεων και διακυβεύουν την εφαρμοσιμότητα πολλών CF αλγορίθμων σε ρεαλιστικά σενάρια. Χτίζοντας πάνω στη διαίσθηση πίσω από τον αλγόριθμο NCDawareRank - μίας γενικής μεθόδου υπολογισμού διανυσμάτων κατάταξης ιεραρχικά δομημένων γράφων - και της σχετικής με αυτόν έννοιας της NCD εγγύτητας, προβαίνουμε σε μία μοντελοποίηση του συστήματος με τρόπο που φωτίζει τα ενδημικά του χαρακτηριστικά και προτείνουμε έναν νέο αλγοριθμικό πλαίσιο συστάσεων, τον Αλγόριθμο 1. Στο επίκεντρο της προσέγγισής μας είναι η προσπάθεια να συνδυάσουμε τις άμεσες με τις NCD, ``γειτονιές'' των αντικειμένων ώστε να πετύχουμε μεγαλύτερης ακρίβειας χαρακτηρισμό των πραγματικών συσχετισμών μεταξύ των στοιχείων του χώρου αντικειμένων, με σκοπό την βελτίωση της ποιότητας των συστάσεων αλλά και την αντιμετώπιση της εγγενούς αραιότητας και των προβλημάτων που αυτή συνεπάγεται. Για να αξιολογήσουμε την απόδοση της μεθόδου μας υλοποιούμε και εφαρμόζουμε τον Αλγόριθμο 1 στο κλασικό movie recommendation πρόβλημα και παραθέτουμε μια σειρά από πειράματα χρησιμοποιώντας τo MovieLens Dataset. Τα πειράματά μας δείχνουν πως ο Αλγόριθμος 1 με την εκμετάλλευση της ιδέας της NCD εγγύτητας καταφέρνει να πετύχει λίστες συστάσεων υψηλότερης ποιότητας σε σύγκριση με τις άλλες state-of-the-art μεθόδους που έχουν προταθεί στη βιβλιογραφία, σε ευρέως χρησιμοποιούμενες μετρικές (micro- και macro-DOA), αποδεικνύοντας την ίδια στιγμή πως είναι λιγότερο επιρρεπής στα προβλήματα που σχετίζονται με την αραιότητα και έχοντας παράλληλα ανταγωνιστικό προφίλ πολυπλοκότητας και απαιτήσεις αποθήκευσης. / The purpose of this master's thesis is to study and develop a new algorithmic framework for collaborative filtering (CF) to generate recommendations. The method we propose is based on the exploitation of the hierarchical structure of the item space and intuitively ``stands'' on the property of Near Complete Decomposability (NCD) which is inherent in the structure of the majority of hierarchical systems. Collaborative Filtering is one of the most successful families of recommendations methods. The great impact of CF on Web applications, and its wide deployment in important commercial environments, have led to the significant development of the theory, with a wide variety of algorithms and methods being proposed. However, despite their unprecedented success, CF methods present some important limitations including scalability and data sparsity. These problems have a negative impact of the quality of the recommendations and jeopardize the applicability of many CF algorithms in realistic scenarios. Building on the intuition behind the NCDawareRank algorithm and its related concept of NCD proximity, we model our system in a way that illuminates its endemic characteristics and we propose a new algorithmic framework for recommendations, called Algorithm 1. We focus on combining the direct with the NCD `` neighborhoods'' of items to achieve better characterization of the inter-item relations, in order to improve the quality of recommendations and alleviate sparsity related problems. To evaluate the merits of our method, we implement and apply Algorithm 1 in the classic movie recommendation problem, running a number of experiments on the standard MovieLens dataset. Our experiments show that Algorithm 1 manages to create recommendation lists with higher quality compared with other state-of-the-art methods proposed in the literature, in widely used metrics (micro- and macro- DOA), demonstrating at the same time that it is less prone to low density related problems being at the same time very efficient in both complexity and storage requirements.

Métodos convencionais para a confecção de próteses totais envolvem uma série de procedimentos técnicos complexos. No entanto, métodos simplificados podem ser tão efetivos quanto os convencionais, porém com menor gasto de tempo e recursos, sem representar prejuízos aos usuários. Assim, o objetivo deste estudo foi comparar um método simplificado de confecção de próteses totais a outro convencional, tendo como variáveis a qualidade de vida associada à saúde bucal (QVSB), a satisfação dos pacientes e qualidade das próteses. A amostra foi formada por pacientes desdentados solicitando tratamento com próteses totais bimaxilares. Os participantes foram divididos aleatoriamente em dois grupos: Grupo S (n=19), que recebeu próteses confeccionadas por um método simplificado, e Grupo C (n=20), que recebeu próteses confeccionadas de forma convencional. Antes dos tratamentos e após 3 e 6 meses da instalação das próteses, a QVSB foi avaliada por meio do questionário OHIPEDENT e a satisfação dos usuários por meio de um questionário específico e escala visual analógica. A qualidade das próteses foi avaliada após 3 meses por um especialista. Os dois grupos foram comparados por meio de testes adequados à distribuição dos dados (&alpha;=5%). A QVSB e qualidade das próteses foram similares nos grupos C e S. Não houve diferença entre os grupos quanto à satisfação geral avaliada pelos dois questionários. Diferenças em relação à satisfação dos usuários com aspectos específicos das próteses só ocorreram na avaliação dos 3 meses, não persistindo na segunda avaliação. Conclui-se que métodos simplificados são capazes de produzir próteses totais de qualidade comparável às geradas por métodos convencionais, influenciando a QVSB e a satisfação de seus usuários de forma similar. / Complete denture fabrication involves a series of complex technical procedures. Nevertheless, simplified methods may be as effective as conventional ones albeit the lesser use of time and resources, without disadvantage to the denture wearer. Thus, the purpose of this study was to compare a simplified method for complete denture fabrication to a conventional protocol in a randomized controlled trial in terms of oral health quality of life (OHRQoL), patient satisfaction and denture quality. A sample was created by edentulous patients requesting treatment with maxillary and mandibular complete dentures. Participants were randomly allocated into two study groups. Group S (n=19), which received dentures fabricated by a simplified method, and Group C (n=20), which received conventionally fabricated dentures. Before the interventions and after 3 and 6 months following insertion, OHRQoL was evaluated by means of OHIP-EDENT questionnaire and patient satisfaction was analyzed by a visual analogue scale and a specific questionnaire. Denture quality was assessed 3 months after delivery by a prosthodontist. Groups were compared by means of statistical tests suitable for the distribution of data (&alpha;=5%). Groups presented no difference for OHRQoL, denture quality and patient general satisfaction. Differences regarding to patient satisfaction with specific aspects of the dentures were found after 3 months, but were insignificant at 6 months. It was concluded that the simplified method is able to produce complete dentures of a quality comparable to those produced by the conventional protocol, influencing the OHQoL and satisfaction of their wearers similarly

Made available in DSpace on 2014-06-11T19:28:57Z (GMT). No. of bitstreams: 0 Previous issue date: 2005-12-15Bitstream added on 2014-06-13T20:18:38Z : No. of bitstreams: 1 mazaro_jvq_me_araca.pdf: 2035782 bytes, checksum: e67d1a0017e9c678266d158062acc962 (MD5) / Universidade Estadual Paulista (UNESP) / A relação existente entre os métodos de processamento das resinas acrílicas e a espessura de resina das bases de dentaduras, bem como a associação com o tamanho e forma do arco maxilar, tem sido um assunto bastante discutido no que diz respeito à possíveis alterações no posicionamento dos dentes e selamento posterior de próteses totais maxilares. Sendo assim, o propósito desse trabalho foi avaliar a movimentação dentária que ocorre durante o processamento de próteses totais maxilares com três diferentes espessuras de base, frente a dois métodos de inclusão e submetidas à polimerização por microondas. Quarenta e duas (42) amostras foram aleatoriamente divididas em 6 grupos de 7 amostras cada, respeitando, evidentemente, a espessura da base (1,25 mm - 2,50 mm - 3,75 mm) e o tipo de revestimento em mufla (silicone e gesso pedra). Pontos foram demarcados sobre os dentes artificiais para permitir a mensuração das R ee ssum o amostras através do software AutoCad. A diferença das médias dos segmentos entre o modelo encerado e demuflado de cada grupo foi submetida à analise de variância (ANOVA) e teste de Tukey. De acordo com os resultados obtidos pode-se concluir que: todas as técnicas de processamento juntamente com as diferentes espessuras de base de prótese total avaliadas apresentaram alteração na posição dos dentes artificiais após o processamento. A técnica de inclusão com barreira de silicone foi a que apresentou as maiores alterações dimensionais, independentemente da espessura. Na análise dos segmentos, houve uma maior alteração dos segmentos A/B/C (Triângulo maior) com relação aos segmentos D/E/F (Triângulo menor). Independente do tipo de inclusão, não houve diferença estatística entre as espessuras das bases (p<0,059), entretanto, analisando o comportamento de alteração, as prótese totais com bases mais finas apresentaram maior... . / The existent relationship between the methods of processing of the acrylic resins and the thickness of dentures bases resin, as well as the association with the size and form of the maxillary arch, it has been a subject quite discussed with regard to possible alterations in the teeth positioning and maxillary complete denture postdamming. So that, the aim of the study was to evaluate the dental movement that it happens during the processing of maxillary complete dentures with three base thickness different, front of two inclusion methods and submitted to the microwaves polymerization. Forty two (42) samples were randomly divided in 6 groups of 7 samples each, respecting, evidently, the base thickness (1,25 mm - 2,50 mm - 3,75 mm) and the type in flask investment (silicone and plaster stone). Points were demarcated on the artificial teeth to allow the measurement of the samples through the AutoCad software. The averages difference of the segments between the Ab ss tt rr a cc tt waxed model and deflasked of each group was submitted to it analysis of variance (ANOVA á=0,05) and Tukey test. In agreement with the obtained results it can be conclusion that: all the processing techniques together with the different thickness of complete denture base evaluated, presented alteration in the artificial teeth positionig after the processing. The silicone flasking technique was that presented the largest dimensional alterations, independently of the thickness. In the segments analysis, there was a larger alteration of the segments A/B/C (larger Triangle) regarding the segments D/E/F (smaller Triangle). Independent of the flasking type, there was not difference statistics among the thickness of the bases (p <0,059), however, analyzing the alteration behavior, thinner bases presented larger movement in the position of the artificial teeth than thicken base that complete denture them. The completed... (Complete abstract, click electronic address below).