In this study the author attempts to evaluate structural evolutionary networks after turbulence using reconstructive logic. Analysing contingent stages of evolution provide for an in-depth study of the various forces impacting on a non-linear social system's recovery after turbulence. Similarly, such a mode of analysis allows for studying the inter-relationships among a system's endogenous and exogenous forces. Although each crisis is unique, yet an analysis of previous events would pave the way to generate learning curves geared towards the prevention, or at least mitigation, of the impact of future similar events. A detailed conceptual analysis of decision-making contexts and behavioural styles under varying levels of turbulent environmental states are evaluated to illustrate the direct and indirect inter-relationships among the actors/participants and their contributions to the creation and prolongation of a state of turbulence and instability. Since environmental states relate to the perceptions of the actors involved and their interactions over time, the connection between the two main environmental levels, namely, the system's internal micro-environmental factors - including inherent socio-political contradictions - and its external uncontrollable macro-environmental influences - incorporating regional and international forces - are evaluated. This study primarily deals with contingency planning for system's evolution after crisis. It is essentially a case study of turbulence at the national level of analysis, mainly dealing with the development of normative and predictive transferable policy implications geared towards a system's embarkation on a recovery and reconstruction mode. With this purpose in mind, this research study aims at developing a Reconstruction - Governance Contingency Path Analysis (RGPA) in terms of identifying and evaluating contingent stages of evolution based on an analysis of developmental leadership pathways. This is accomplished through an in-depth analysis of the components and conditions for a system's evolution as well as evaluating the inter-relationship between the system itself and its environment, both at the micro- and macro-levels. To illustrate its application to a specific country, the RGPA is applied to the case study of Lebanon / Doctor of Philosophy (PhD)

Reproduction de : Thèse d'exercice : Médecine : Nancy 1 : 2004. / Titre provenant de l'écran-titre.

The face is an integral part of one’s self-concept and unquestionably the most important attribute used to distinguish one's identity. A growing body of literature demonstrates that any condition that results in facial disfigurement can have a profound adverse impact on one's psychological and social functioning. In this respect, patients with facial disfigurements are at higher risk to experience psychosocial difficulties than others. Owing to injuries or illnesses such as cancer, patients undergo reconstructive surgeries both to recover their facial function and to reduce the adverse impact of facial disfigurements on their psychosocial functioning. However, since surgical planning and evaluation of reconstructive outcomes still relies heavily on surgeons' qualitative assessments, it is challenging to measure surgery outcomes and, therefore, difficult to improve surgical practice. Thus, this dissertation research aims to help patients suffering from facial disfigurement by developing quantitative measures that are 1) related to human perception of faces, and 2) that account for patient's internal status (i.e., psychosocial functioning). Such measures can be used to improve surgical practice and assist patients with disfigurement to be psychosocially adjusted. Specifically, this dissertation proposes quantitative measures of facial morphology and expression that are closely related to overall facial attractiveness and a patient's psychosocial functioning. Such measures will allow surgeons to quantitatively plan and evaluate reconstructive surgeries. In addition, this dissertation introduces a modeling technique to simulate disfigurement on novel faces with control on the type, location, and severity of disfigurement. This modeling technique is important since it can help patients with facial disfigurement gain a more accurate understanding of how they are viewed in society, which has a strong potential to facilitate their psychosocial adjustment. This dissertation provides a new perspective on how to help patients with facial disfigurement address challenging problems in facial reconstruction, aesthetic understanding, and psychosocial actualization. It is hoped that this work has shown that multiple benefits could be realized from future studies utilizing the modeling technique to understand human perception of facial disfigurement and thereby to develop quantitative measures that are closely associated with human perception. / text

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2007. / Härtill 4 uppsatser.

Submitted by JORGE LUIS ALVAREZ GÓMEZ null (jorgeluisalgo@hotmail.com) on 2016-09-30T08:45:24Z No. of bitstreams: 1 DISERTAÇAO MESTRADO JLAG 29_09_16.docx.pdf: 14985307 bytes, checksum: 2a43232024785aafb3f29376d44310e4 (MD5) / Approved for entry into archive by Juliano Benedito Ferreira (julianoferreira@reitoria.unesp.br) on 2016-09-30T13:41:01Z (GMT) No. of bitstreams: 1 alvarezgomez_jl_me_jabo.pdf: 14985307 bytes, checksum: 2a43232024785aafb3f29376d44310e4 (MD5) / Made available in DSpace on 2016-09-30T13:41:01Z (GMT). No. of bitstreams: 1 alvarezgomez_jl_me_jabo.pdf: 14985307 bytes, checksum: 2a43232024785aafb3f29376d44310e4 (MD5) Previous issue date: 2016-07-29 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Tradicionalmente um enxerto é realizado em um leito receptor coberto por tecido de granulação saudável, e na atualidade, as células tronco mesenquimais representam uma excelente alternativa para estimular a cicatrização de feridas agudas e crônicas. Sendo assim, este trabalho teve por objetivo avaliar os efeitos de células tronco mesenquimais xenógenas na cicatrização de auto-enxertos cutâneos em leito receptor sem tecido de granulação de coelhos. Foram utilizados 60 coelhos, divididos em três grupos de 20 pacientes. O primeiro grupo (GIL) e o segundo (GIV) receberam tratamento de 2 x106 células tronco , por vias intralesional e intravenosa respetivamente, enquanto o grupo controle (GC) recebeu apenas o auto-enxerto cutâneo. Na avaliação macroscópica, enxertos dos grupos GIL e GIV apresentaram melhor coloração comparado com o grupo controle, no entanto, na avaliação microscópica as variáveis inflamação, reepitelização, necrose e neovascularização não mostraram diferencia significativa entre os três grupos (p>0,05). Conclusão: a reepitelização dos auto-enxertos cutâneos em malha em leito receptor desprovido de tecido de granulação em coelhos (Oryctolagus cuniculus ) provavelmente não precisam de técnica adjuvante para estimular a cicatrização. A versatilidade da malha permite uma aderência estável ao leito receptor, e através das fendas criadas permite a eliminação da secreção inflamatória, evitando assim a presença de seroma e garantindo a nutrição e revascularização do enxerto. / Traditionally, a graft is performed in a healthy granulation tissue bed, although nowadays, the mesenchymal stem cells represent an excellent alternative to stimulate wound healing in a recipient bed without a healthy granulation tissue bed. Thus, this study aimed to evaluate the effects of mesenchymal stem cells xenogeneic at the healing of skin autografts in a recipient bed without granulation tissue in rabbits. A total of 60 rabbits were divided into three groups of 20 patients. The first (GIL) and the second group (GIV) were treated with 2x106 intralesional and intravenous stem cells respectively; meanwhile the control group (CG) received only skin autograft. At the macroscopic examination, the grafts GIL and GIV groups showed better color than the control group, however, microscopic evaluation of the variables: inflammation, re-epithelization, necrosis and angiogenese showed no significant difference among the three groups (p>0,05). Conclusion: reepithelialization of meshed skin autografts from recipient bed without granulation tissue in rabbits (Oryctolagus cuniculus) probably does not need an adjuvant technique to stimulate wound healing. The versatility of the mesh allows a stable adherence to the recipient bed, and through the created slits allows the evacuation of inflammatory secretion, avoiding the presence of seroma and providing nutrition and graft revascularization.

This qualitative study investigated the group process and impact of pre-group feedback information on individuals in an eight-week therapy group. The feedback information was based on group members' results on the Structural Analysis of Social Behavior (SASB) Intrex questionnaire given before the group began. The Intrex is based on Interpersonal Reconstructive Therapy (IRT) theory, which is a combination of interpersonal psychoanalysis, attachment theory, operant conditioning, and studies of imitative learning, and has been utilized primarily in an individual treatment format. Because only a limited number of treatment strategies have utilized IRT theory in the group treatment setting, and because group treatment results often rival those of individual therapy, the researcher chose to introduce IRT information into group therapy in a grounded-theory study. IRT information was given to the group leader and members mainly to inform them of patterns. They were the primary source of IRT feedback in the group sessions. The purpose of this study was to gain an in-depth understanding of the process experience of this group and the potential impact of IRT theory-based feedback-receiving on this group's therapy. Participants completed the Inventory of Interpersonal Problems (IIP) and the Outcome Questionnaire-45 (OQ-45) at specified points to provide quantitative support for qualitative analyses of group member outcomes. Therapy tapes were transcribed verbatim, watched, and analyzed by two clinical psychology students for important process themes using grounded theory methods. Two main themes were revealed during the qualitative search: 1) Group members tended to express information gained during their interview in covert ways and were highly resistant to overt discussions of early patterns; and 2) For this particular group, religious beliefs played a large role in how information was processed and the degree to which positive change occurred distilled through their struggle internalizing norms and standards.

In a large body of research, Elizabeth Loftus (1975) first illuminated major concerns about the inaccuracy of eyewitness accounts. The primary goal of the present research was to test whether training regarding common eyewitness mistakes and witness suggestibility could improve eyewitness accuracy. The experimental group watched a presentation on research conducted by Elizabeth Loftus (1975) on eyewitness testimony and suggestibility during a Psychology course. Afterwards, an actor interrupted the classroom and had a discussion with the teacher. Students were asked a series of questions about the disruption. Some of the questions were leading and suggested certain things about the disruption that were inaccurate. After the misleading questions were asked, students were instructed to write a brief summary of what they saw. One week later, the students were asked direct questions about the disruption. A control group did not receive the presentation on eyewitness testimony, but witnessed the exact same event as the experimental group and followed the same procedure. The results suggest that participants who were trained were not as influenced as participants in the control group. Additionally, students in the control group reported the actor's behavior as more threatening than did the experimental group. This research not only adds to the existing literature, but has the potential to improve current eyewitness identification procedures in order to strengthen our justice system.

No description available.

Bakgrund: Trauma, tumörsjukdom, infektioner och cirkulationsrubbningar kan leda till förlust av kroppsdel. Forskning i ämnet är ofta medicinskt inriktad på smärtproblematik eller praktiska följder, medan patienters upplevelser och psykosocial påverkan hamnar i skymundan. Syfte: Syftet med den här uppsatsen är att beskriva psykosociala aspekter i upplevelsen av att leva med en förlorad kroppsdel. Metod: Litteraturstudie med kvalitativ ansats baserad på elva kvalitativa artiklar. Resultat: Att förlora en kroppsdel kan leda till påverkad självbild och psykosocial påverkan. Detta presenteras i huvudtemat att hantera en ny livssituation med underliggande teman jag är, jag ser ut, jag kan och socialt stöd. Slutsats: Vid förlust av kroppsdel oavsett etiologi kan självbilden påverkas i någon riktning. Sexuallivet såväl som vardagliga sysslor kan påverkas vilket i sin tur påverkar livskvaliteten. Att anpassa sig till en protes kan underlätta både den fysiska och den psykosociala aspekten, vilket påverkar självbilden positivt. Detta ämne har under det senaste årtiondet beforskats, men detta behöver förankras i klinisk praxis. Klinisk Betydelse: Genom att belysa de psykosociala aspekterna av att förlora en kroppsdel bidrar föreliggande uppsats till att öka förståelsen amputerade och mastektomerade patienters situation Nyckelord: amputation, mastektomi, protes, rekonstruktiv kirurgi, självbild, sexualitet / Background: Trauma, tumors, infections and vascular disease could lead to loss of limb. Research in the subject is often aimed at medical issues or practical matters, while the experiences and psychosocial aspects are being overlooked. Purpose: The purpose of this dissertation is to describe psycosocial aspects of the lived experience of living with a lost bodypart. Method: A review of qualitative approach based on eleven qualitative articles. Results: Losing a body part may affect psychosocial elements and self-image. This is being presented in the main theme to adapt to a new aspect of life and three themes: I am, I look like, I'm apt and social support. Conclusion: Loss of a bodypart of variying aetiology can lead to concerns of self- image. Sexuality and daily life activities can be affected, with a loss of quality of life as a consequence. To adapt to a prosthesis can ease both the psycosocial and physiological aspects of this transition, with im proved self-image as a result. This topic has been researched during the last decade, but the knowledge has yet to reach clinical praxis. Clinical significance: This study highlights the psycosocial aspects of losing a body part in order to give a deeper understanding of the needs of these patients. Key words: amputation, mastectomy, prosthesis, reconstructive surgery, self- image, sexuality

Introduction: Though xenogeneic acellular scaffolds are frequently used for surgical reconstruction, knowledge of their mechanical properties is lacking. This study compared the mechanical, histological and ultrastructural properties of various native and acellular specimens. Materials and methods: Porcine esophagi, ureters and skin were tested mechanically in a native or acellular condition, focusing on the elastic modulus, ultimate tensile stress and maximum strain. The testing protocol for soft tissues was standardized, including the adaption of the tissue’s water content and partial plastination to minimize material slippage as well as templates for normed sample dimensions and precise cross-section measurements. The native and acellular tissues were compared at the microscopic and ultrastructural level with a focus on type I collagens. Results: Increased elastic modulus and ultimate tensile stress values were quantified in acellular esophagi and ureters compared to the native condition. In contrast, these values were strongly decreased in the skin after acellularization. Acellularization-related decreases in maximum strain were found in all tissues. Type I collagens were well-preserved in these samples; however, clotting and a loss of cross-linking type I collagens was observed ultrastructurally. Elastins and fibronectins were preserved in the esophagi and ureters. A loss of the epidermal layer and decreased fibronectin content was present in the skin. Discussion: Acellularization induces changes in the tensile properties of soft tissues. Some of these changes appear to be organ specific. Loss of cross-linking type I collagen may indicate increased mechanical strength due to decreasing transverse forces acting upon the scaffolds, whereas fibronectin loss may be related to decreased load-bearing capacity. Potentially, the alterations in tissue mechanics are linked to organ function and to the interplay of cells and the extracellular matrix, which is different in hollow organs when compared to skin.