Purpose Allergy against implant materials is discussed controversially and still not fully understood. Despite these controversies, a relevant number of patients receive hypoallergenic knee implants. The aim of this study was to compare a new coating system with the standard implant in total knee arthroplasty (TKA). Additionally, the influence of proinflammatory cytokines on patient-reported outcome measures (PROMs) was investigated. Methods 120 patients without known metal allergy and without previous metal implants were included. The patients were randomized to receive a coated or standard TKA of the same knee system. 105 patients completed the 5 year follow-up. Patient-reported outcome measures (PROMs) including knee function (Oxford Knee Score, OKS), quality of life (SF36) and UCLA activity scale were assessed. Additionally, several cytokines with a possible role in implant allergy were measured in patient`s serum (IL-1beta, IL-5, IL-6, IL-8, IL-10, IP-10, IFN γ, TNF α). Group comparison was performed using Mann–Whitney U test for continuous values and chi-square test for categorical values. Results There were no differences in PROMs between both groups at any follow-up. The majority of patients demonstrated no elevation of the measured blood cytokines. The blood cytokine pattern after 5 years demonstrated no differences between study groups. There was a significant association between elevated IL-8 values and worse results in the overall OKS (p = 0.041), the OKS function component (p = 0.004), the UCLA activity scale (p = 0.007) and the physical component of SF36 (p = 0.001). Conclusion There were no problems with the new coating during mid-term follow-up and no differences in PROMs between coated and standard TKA. Patients with an increased inflammatory response demonstrated worse functional results, regardless of the implant. Level of evidence I. Clinical trial registration The study protocol was registered in the US National Institutes of Health’s database (http:// www.clini caltr ials. gov) registry under NCT00862511.

Objectif : Comparer les dispositifs de délivrance automatisée d’insuline open-source (DDAI-OS) et les DDAI commerciaux hybrides sur le contrôle glycémique, la qualité de vie rapportée, et la sécurité chez des adultes avec diabète de type 1 (DT1). Méthodes : Étude prospective, observationnelle, de non-infériorité, comparative et en vie réelle, incluant 78 adultes canadiens avec un DT1 et utilisant un DDAI ≥ 3 mois. Quatre semaines de mesure continue du glucose ont permis d’évaluer le % temps passé dans la cible de glucose (%TIR, 3,9-10,0 mmol/L). Les indicateurs de qualité de vie ont été évalués par des échelles de mesure validées. Les mesures de sécurité sont le temps passé en hypoglycémie, la survenue d’hypoglycémie sévère ou d’acido-cétose et les problèmes techniques. Résultats : Les participants du groupe DDAI-OS étaient non inférieurs au groupe DDAI commercial sur le %TIR (78,3% [SD 11,0] vs. 71,2% [SD 10,9], différence moyenne 7,2% [95% CI 1,9% à 12,5%], p<0.001), même après ajustement sur plusieurs facteurs confondants. Le groupe DDAI-OS a passé plus de temps en hypoglycémie (<3,9 mmol/L) (3,9% [SD 3,1] vs. 1,8% [SD 1,3], p<0.001) et a rapporté moins de peur de l’hypoglycémie. Aucun épisode d’hypoglycémie sévère ou d’acido-cétose n’a été rapporté, avec un nombre de problèmes techniques similaires entre les deux groupes. Conclusion : Les DDAI-OS hybrides sont sécuritaires et non inférieurs aux DDAI commerciaux hybrides en termes de %TIR chez des adultes vivant avec un DT1 dans des conditions de vie réelle. Nos résultats soutiennent que les DDAI-OS peuvent être considérés pour la gestion du DT1. / Background: Comparison between unregulated open-source (OS) automated insulin delivery (AID) systems and commercial AID (C-AID) systems remains scarce. Objective: Compare both AID systems regarding glucose management, patient-reported outcomes (PROs), and safety among adults with type 1 diabetes (T1D) in real-life conditions. Design: Prospective, observational, non-inferiority, comparative, real-world study. Setting: On-site (a diabetes clinic in Montreal) and online (a T1D registry and social media platforms) across Canada. Participants: 78 adults with T1D, having used an AID system for ≥ 3 months, and living in Canada (26 OS-AID and 52 C-AID users). Measurements: 4-week’s data from a blinded continuous glucose monitor were used to assess effectiveness (primary outcome: 24h time in range % [TIR%], with a non-inferiority margin of 5%). Other outcomes included PRO measures using validated scales. Safety outcomes included time spent in hypoglycemia, severe hypoglycemia, diabetic ketoacidosis (DKA), and technical issues. Results: OS-AIDs were non-inferior to C-AIDs regarding 24h TIR% (78.3% [SD 11.0] vs. 71.2% [SD 10.9], mean difference 7.2% [95% CI 1.9% to 12.5%], p<0.001), even after adjusting for various confounding factors. OS-AIDs spent more time in hypoglycemia (<3.9 mmol/L) than C-AIDs (3.9% [SD 3.1] vs. 1.8% [SD 1.3], p<0.001) and reported less fear of hypoglycemia. No severe hypoglycemia or DKA was reported in either group, with a similar occurrence rate of technical issues between groups. Conclusion: OS-AIDs are safe and non-inferior to C-AIDs for TIR% among adults with T1D in real-world settings. Our findings support that both OS-AID and C-AID systems can be considered for T1D management.

No description available.

Bakgrund Femoroacetabulär impingement (FAI) syndrom är en allt vanligare rörelserelaterad funktionsnedsättning i höften, relaterat till en prematur kontakt mellan proximalafemur och acetabulum. Fysioterapi har visat god effekt vid behandlingen av FAI men aktuell forskning är begränsad och konsensus kring bästa behandlingsmetod saknas. Syfte Identifiera och kategorisera vilka fysioterapeutiska interventioner som används vid behandlingen av femoroacetabulär impingement (FAI), hur interventionerna utvärderas och presentera effekten av dessa interventioner. Metod Kartläggande litteraturöversikt. I februari 2022 genomfördes en elektronisk sökning efter vetenskapliga originalstudier från 2012, i databaserna PubMed, CINAHL och PEDRO. Totalt 1672 studier granskades varav 23 inkluderades. Huvudtyper av interventioner identifieras och kategoriserades med stöd av ICF-ramverket utifrån avsett syfte. Resultat Ur 23 inkluderade studier identifierades 36 huvudtyper av interventioner. Av dessaka tegoriseras 25 interventioner under ICF komponenten kroppsfunktioner. Hälften av interventionerna kategoriseras under neuromuskuloskeletala och rörelserelaterade funktioner. Av totalt 33 olika patientrapporterade utfallsmått (PROM) utgjorde iHOT-33, mHHS och NAHS de tre vanligast förekommande. Minst ett av de rekommenderade utfallsmåtten iHOT-12/-33, HAGOS och HOS användes i 70% av studierna. Alla inkluderade randomiserade kontrollerade studier visar signifikanta förbättringar vid användandet av fysioterapeutiska interventioner för FAI avseende PROM vid uppföljning jämfört baslinjen. Slutsats Utformningen av fysioterapeutiska interventioner vid FAI varierar, även om majoriteten syftar till att påverka neuromuskuloskeletala och rörelserelaterade funktioner. Det är möjligt att utifrån interventionens syfte klassificera interventioner vid FAI enligt ICF-ramverket. Rekommenderade diagnosspecifika PROM används i relativt hög utsträckning, till skillnad från de rekommenderade livskvalitetsmåtten. Studien belyser i likhet med tidigare forskning, bristen på konsensus gällande den fysioterapeutiska behandlingen vid FAI. / Background Femoroacetabular impingement (FAI) syndrome is an increasingly prevalent movement related disability in the hip, related to premature contact between the femur and acetabulum. Physiotherapy has shown efficacy in treating FAI, but research is limited and shows a lack of consensus regarding best conservative care. Purpose This study aims to identify and categorize the type of physiotherapeutic interventions used in treating FAI, present the effects of these interventions and to map the use of outcome measures. Methods Scoping review. In February 2022 an electronic search was conducted across the databases PubMed, CINAHL and PEDRO. A total of 1672 studies were identified of which 23 met eligibility. Main types of interventions were identified and classified based on aim using the ICF-framework. Results A total of 36 main types of interventions were identified. Out of these, 25 could be categorized under the ICF-component body functions and 18 under neuromusculoskeletal and movement-related functions. Out of 33 total PROMs, iHOT-33, mHHS and NAHS saw most use. At least one of the recommended PROMs was used in 70% of the studies. Included RCT: s show significant improvement on a variety of outcome scores. Conclusion Interventions treating FAI varies, with most targeting neuromusculoskeletal and movement-related functions. Categorization based on the aim of interventions is possible using the ICF-framework. Recommended hip-specific outcome measures are used to a greater extent compared to the more general quality of life measures. This study, in accordance with earlier research, illustrates the lack of consensus regarding the physiotherapeutic care of FAI.

Le but de cette recherche est d’obtenir une meilleure compréhension de l’incidence des symptômes reliés au trouble bipolaire sur l’efficacité personnelle et collective dans un contexte d’équipe pour améliorer l’intégration des employés avec ce trouble en milieu de travail. Les données utilisées sont de type primaire. Elles ont été recueillies auprès de 483 participants à l’aide d’un questionnaire. Des analyses structurelles ont ensuite permis de mettre à l’épreuve les cinq hypothèses proposées. Les résultats obtenus illustrent que l’impact des symptômes bipolaires sur le sentiment d’efficacité personnelle et collective serait à la fois indirect et direct. Effectivement, la présence de symptômes bipolaires est susceptible d’augmenter les risques de vivre des conflits interpersonnels et de percevoir de la stigmatisation au travail. La présence de ces deux stresseurs sociaux peut influencer négativement le sentiment d’efficacité personnelle et collective de l’individu. La présence de symptômes bipolaires semble influencer négativement le sentiment d’efficacité personnelle et collective. La contribution empirique de ce mémoire est de mettre en lumière la corrélation entre les symptômes du trouble bipolaire et l’augmentation des conflits interpersonnels et de la stigmatisation internalisée en milieu professionnel. De plus, ce mémoire met en évidence l’impact négatif que peut avoir l’augmentation des conflits et de la stigmatisation internalisée sur l’efficacité personnelle et collective. Sur le plan pratique, ces conclusions fournissent des bases solides pour orienter les politiques et les pratiques en milieu professionnel. Elles suggèrent la nécessité de développer des environnements de travail plus sensibles et inclusifs pour les individus affectés par le trouble bipolaire. Ces résultats incitent également à la mise en place de mesures visant à réduire les conflits interpersonnels et à atténuer la stigmatisation pour promouvoir un meilleur fonctionnement au sein des équipes. / The goal of this research is to obtain a better understanding of the impact of symptoms related to bipolar disorder on personal and collective effectiveness in a team context to improve the integration of employees with this disorder in the workplace. The data used is of primary type. They were collected from 483 participants using a questionnaire. Primary and structural analyzes then made it possible to test the five proposed hypotheses. The results obtained illustrate that the impact of bipolar symptoms on the feeling of personal and collective efficacy is both indirect and direct. Indeed, the presence of bipolar symptoms seems to increase the risks of experiencing interpersonal conflicts and perceiving stigma at work. The presence of bipolar symptoms seems to also influence the feeling of personal and collective efficacy negatively. The empirical contribution of this thesis is to highlight the correlation between bipolar disorder symptoms and the increase in interpersonal conflicts and perceived stigmatization in the professional environment. Furthermore, this thesis demonstrates the negative impact that heightened conflicts and perceived stigmatization can have on personal and collective effectiveness. Practically speaking, these findings provide a solid foundation for guiding policies and practices in the professional sphere. They suggest the necessity of developing more sensitive and inclusive work environments for individuals affected by bipolar disorder. Moreover, these results advocate for implementing measures aimed at reducing interpersonal conflicts and mitigating stigmatization to promote better team functioning.

This thesis explores the impact of two behavioural finance concepts, social psychology and psychology, on household financial decisions. Under social psychology, I investigate whether the variety and intensity of social engagement enhances stock market participation. With regard to psychology, I examine two behavioural biases. First, I investigate whether mental accounting influences portfolio choice in three asset classes and whether financial advice and housing tenure increase (decrease) the effects of mental accounts on portfolio choice. Second, I examine whether households’ self-reported housing wealth are anchored on published house price indices and whether anchoring bias is mediated by market information, mortgage refinancing decisions and social factors. The main contributions and findings in the three studies are as follows. First, although there is an elaborate body of research concerning the relationship between social engagement mechanisms and portfolio choice, most studies investigate specific mechanisms in isolation. Using three waves in the British Household Panel Survey (BHPS), I bring together five social engagement measures in one model and show that socially engaged individuals are more likely to participate in the stock market. Consistent with Granovetter’s (1973) theory of social networks I find that a weak tie (measured by social group involvement) has a positive effect on stock market participation whereas a strong tie (measured by talking to neighbours) has no effect. More trusting individuals are more likely to participate in the stock market, as are those who identify with a political party. In contrast, the degree to which religion is important appears to have little impact. These results are robust using different specifications. Overall, the results of this study demonstrate that the likelihood of stock market participation increases with the variety and intensity of social engagement. Second, despite the established theoretical underpinnings of mental accounting in behavioural portfolio theory (BPT) and recent extensions, not much is known about their implications in real life situations. I use a recent UK household survey, the Wealth and Assets Survey (WAS), which has comprehensive information about financial assets to investigate whether there are differences in the ownership and portfolio share of three asset classes among individuals who exhibit no mental account, a single mental account and multiple mental accounts, and the conditional influences of financial advice, housing, cognitive ability, time preference and risk tolerance. Overall I find that mental accounting together with financial advice and housing tenure explain variations in both the probability of ownership and portfolio share in the three asset classes. Households that exhibit a single mental account have low share of investments in, and are less likely to own, a risky asset when compared to those that exhibit no mental account or exhibit multiple mental accounts. I also find that, when compared to having no mental account, exhibiting a single mental account or multiple mental accounts increases both the probability and investment share in a fairly safe asset but decreases portfolio share in safe assets. In addition, among those that exhibit a single mental or multiple mental accounts, financial advice decreases portfolio share in risky assets and fairly safe assets and increases portfolio share in safe assets. Housing tenure increases both the probability and portfolio share in risky assets, decreases portfolio share in fairly safe assets and increases portfolio share in safe assets. These results are consistent using multi-equation regressions, sub-samples, reparametrised variables and poisson regressions. Finally, as little is known about how households derive the self-reported house prices estimates that are commonly used to determine housing wealth, the third study examines whether households are anchored on published house price indices. The key conjecture is that, while assessing the values of their homes, homeowners place more weight on house price news at the expense of property characteristics and other market information. I find support for this hypothesis using sixteen waves of the BHPS, multiple methods, and both regional and national house price indices. I conclude that changes in self-reported housing wealth are anchored on changes in published house price indices. Specifically, ownership through a mortgage and greater financial expectations increase anchoring effects while mortgage refinancing decreases the effects. Moreover, use of money raised from refinancing for home investment, as opposed to other consumption purposes, has a positive association with change in self-reported house value and both uses reduce anchoring bias. In addition, I find that computer use increases anchoring bias and, among social engagement mechanisms, religiosity reduces anchoring while other measures have no effect. These results are robust to internal instrumental variables, national aggregate house prices, alternative indices and sub-samples.

Les facteurs de risque de troubles musculo-squelettiques(TMS) tels que les facteurs physiques, organisationnels et psychosociaux sont un défi commun pour les industries de l'assemblage automobile qui entrainent des effets indésirables sur le système et les humains. L’ergonomie a déjà été intégrée dans les systèmes de production de ces industries pour la prise en charge de la prévention des TMS. La question est de savoir si l'approche ergonomique actuelle des industries automobiles, sur la base de normes à l'entreprise et des méthodes d'observation, peut fournir une connaissance partagée des facteurs ergonomiques pour les divers intervenants et pour faciliter l'amélioration des conditions de travail. Cette étude aborde la problématique du positionnement des différents méthodes d'évaluation (utilisées par les différents intervenants) et compare les résultats et apports de chaque méthode d'évaluation. Cette thèse propose que la procédure actuelle d'évaluation des risques de TMS ne favorise pas une connaissance partagée entre les intervenants dans les industries automobiles. On constate que les évaluations par auto-questionnaire (opérateurs) sont significativement différentes de celles issues des méthodes d'observation (ergonome) et des mesures directes (analyse biomécanique). Cependant, les opinions et jugements des opérateurs concernant les facteurs ergonomiques sont importants pour faciliter la réussite d'une approche ergonomique. Un entretien structuré et systématisé, basé sur des données objectives (Video-observations ou de mesure directe) liées aux activités et stratégies des opérateurs, pourrait être une procédure appropriée pour faire progresser l'ergonomie des situations de travail. Enfin, la connaissance tirée de cette thèse souligne que la variabilité des tâches dans l’industrie automobile nécessite une approche ergonomique qui partage les connaissances des risques entre les intervenants. Dans cette approche, les attitudes et les comportements des opérateurs sont pris en compte dans les projets d’amélioration continue. De plus, la participation des intervenants devrait être intégrée afin d'améliorer la prise en compte de l'ergonomie dans la production. Une synthèse de cette thèse en Français a été fournie dans l’annexe première. / Musculoskeletal risk factors such as physical, organizational and psychosocial factors are a common challenge for the automotive assembly industries and result in adverse human and system effects. Ergonomics has already been integrated inthe production systems of such factories to eliminate work related musculoskeletal disorders (WR-MSDs). The issue is whether the current ergonomic approach of car industries, based on corporate standards and observational methods, can provide a shared knowledge of ergonomic factors for various stakeholders and facilitate ergonomic improvement. This study focuses on the positioning of the different assessment methods (used by various stakeholders), agreement between their results in evaluation of physical risk factors and the influence of intervention and improvement following ergonomic assessment. This thesis proposes that the current procedure of risk factor assessment can not provide ashared knowledge and representation of risks between stakeholders in manufacturing industries. It was found that the operators’ assessments of risk factors (self-reported questionnaire) were significantly different from those assessed by observational methods (ergonomist) and direct measurement. However, the operators’ opinions and judgments of ergonomic factors of a job are of particular importance to the success of an ergonomic approach. A structured interview based on objective data (video-observation or direct measurement) linked the activities and strategies of atrisk operators might be an appropriate procedure to advance ergonomics.The knowledge gained from this study emphasizes that the variable nature of tasks in manufacturing industries needs an ergonomic approach which shares knowledge and representation of risks between stakeholders. In such an approach, attitudes and behaviors of operators are taken into consideration in developing new intervention processes, organizational and technical remedies. Moreover, involvement of stakeholders should be integrated and this should result in improving production ergonomics.

Contemporary conceptual models of health emphasize the importance of patient-based outcomes and recognize the complexity involved in their assessment. Various health conditions, personal, social, and environmental factors, are all thought to contribute to individual’s quality of life. However, the impact of orthodontic treatment on Oral Health-related Quality of Life (OH-QOL) outcomes in children has not yet been systematically studied. Hence, this research was planned to assess the effect orthodontic treatment has on pediatric OH-QOL outcomes. Further, the important moderational role of children’s psychological assets on OH-QOL reports is explored. Following completion of a preliminary study to confirm the psychometric properties of the Child Perception Questionnaire (CPQl1-14), the current two-phase study was undertaken. This consisted of a cross-sectional study examining the relationship among Self-Esteem (SE), malocclusion, and OH-QOL, and a longitudinal study examining the influence of orthodontics and children’s Psychological Wellbeing (PWB) on OH-QOL reports. This PhD dissertation is presented in the “Publishable Style”. The journals which hold the copyrights for the papers published from this thesis have given permission for the reproduction of the text and figures for this dissertation. The preliminary data confirmed that the CPQ11-14 is sensitive to change when used with children receiving orthodontic treatment. Our cross-sectional findings indicated that the impact of malocclusion on OH-QOL is substantial in children with low SE and identified SE as a salient determinant of OH-QOL in children seeking orthodontic treatment. Longitudinal data, on the other hand, detected significant improvement of OH-QOL outcomes after orthodontic treatment. As postulated, these improvements were most evident for the social and emotional domains of OH-QOL. However, covariate analysis emphasized the important role psychological factors play in moderating OH-QOL reports, as children with better PWB were more likely to report better OH-QOL regardless of their orthodontic treatment status. These results substantiate the validity of contemporary models of patient-based outcomes linking biological, personal, social, and environmental factors. Researchers and clinicians are encouraged to adopt this forward thinking approach when dealing with children with oro-facial conditions. Further studies with larger samples and longer follow-ups would be of value to expand on these findings.

Contemporary conceptual models of health emphasize the importance of patient-based outcomes and recognize the complexity involved in their assessment. Various health conditions, personal, social, and environmental factors, are all thought to contribute to individual’s quality of life. However, the impact of orthodontic treatment on Oral Health-related Quality of Life (OH-QOL) outcomes in children has not yet been systematically studied. Hence, this research was planned to assess the effect orthodontic treatment has on pediatric OH-QOL outcomes. Further, the important moderational role of children’s psychological assets on OH-QOL reports is explored. Following completion of a preliminary study to confirm the psychometric properties of the Child Perception Questionnaire (CPQl1-14), the current two-phase study was undertaken. This consisted of a cross-sectional study examining the relationship among Self-Esteem (SE), malocclusion, and OH-QOL, and a longitudinal study examining the influence of orthodontics and children’s Psychological Wellbeing (PWB) on OH-QOL reports. This PhD dissertation is presented in the “Publishable Style”. The journals which hold the copyrights for the papers published from this thesis have given permission for the reproduction of the text and figures for this dissertation. The preliminary data confirmed that the CPQ11-14 is sensitive to change when used with children receiving orthodontic treatment. Our cross-sectional findings indicated that the impact of malocclusion on OH-QOL is substantial in children with low SE and identified SE as a salient determinant of OH-QOL in children seeking orthodontic treatment. Longitudinal data, on the other hand, detected significant improvement of OH-QOL outcomes after orthodontic treatment. As postulated, these improvements were most evident for the social and emotional domains of OH-QOL. However, covariate analysis emphasized the important role psychological factors play in moderating OH-QOL reports, as children with better PWB were more likely to report better OH-QOL regardless of their orthodontic treatment status. These results substantiate the validity of contemporary models of patient-based outcomes linking biological, personal, social, and environmental factors. Researchers and clinicians are encouraged to adopt this forward thinking approach when dealing with children with oro-facial conditions. Further studies with larger samples and longer follow-ups would be of value to expand on these findings.

En s'appuyant sur les développements conceptuels apportés à la théorie de l'activité par la psychologie du travail, cette recherche se propose d'explorer la genèse et les fonctions des instruments dans la conduite des activités des sujets malades. La recherche s'appuie sur l'analyse de quatorze entretiens conduits auprès de personnes affectées par une ou plusieurs maladies chroniques sévères. Elle explore comment le sujet malade chronique déploie des " agir sur soi " au travers de ses activités. Elle démontre comment le sujet s’approprie et utilise pour ce faire, des artefacts et des instruments, élabore des stratégies et met en place des dispositifs pour étayer son travail quotidien et sa présence au monde. En s'appuyant sur les concepts de la théorie instrumentale élargie (Rabardel), sur l'activité médiatisée (Vygotski) et sur l’activité au service du maintien de soi en vie en santé (Tourette-Turgis), l'analyse des matériaux identifie trois catégories d'instruments (matériels, non matériels et mixtes) utilisés par les participants de l'étude. Ces instruments semblent remplir des fonctions d'organisateurs d'activités et de transformations des activités et des sujets. / Based on the conceptual developments brought to the theory of the activity by occupational psychology, this research explores the genesis and the functions of the instruments used by the subjects living with a chronic disease in their daily life given that patient ‘s participation in their own care is conceived as a work. The research is based on analysis of fourteen interviews conducted with people affected by one or more severe chronic diseases. It explores and analyses different situations describing how the subject affected by a chronic disease creates, invents different means to « act on oneself » in order to stay alive . This research describes how participants living with one or several chronic diseases use artefacts, tools, instruments , strategies to maintain active the multiple dimensions of their involvement with the world. Using different conceptual frameworks of research on work such as extended instrumental theory ( Rabardel), mediated activity ( Vygotski), the patient’s work ( Tourette-Turgis), content analysis of interviews shows three different categories of instruments ( material, intangible, mixted ) used by the participants of the study. These instruments seem to fulfill the functions of organizers of activities and transformations of the activities and the subjects.