The role of governance style, institutional capacity and regulatory culture in the adoption of ISO14001: the case of Athens International Airport (AIA)

This thesis examines the development of ISO14001 - an international environmental management standard - within the Greek context. Numerous organisations in Greece are adopting schemes for environmental management, but the analysis examines the processes of adopting and implementing ISO14001 in a single organisation, by examining in-depth an international airport's participation in ISO14001. The rationale for this approach is to understand the "diffusion" of a notionally global policy instrument, by investigating the way in which ISO14001 is implemented in particular national settings through the concepts of institutional capacity, regulatory culture and governance style. The social and institutional aspects of environmental management are crucial here: in any policy implementation situation, in spite of complex mechanisms seeking to deliver more sustainable activities, there are likely to be disputable outcomes in the implementation of the scheme. In particular this research illustrates the ambiguous nature of the institutionalisation process itself and of the uncertain power available to states and other bodies to implement ISO14001. The findings illuminate the balance of forces promoting ISO14001 in Greece, where multi-national companies and supply-chain pressure are being joined by assertive - if not always effective - state action. The research identifies possible tensions between government policies, business initiatives and the growth of voluntarism as a force for better environmental management in Greece. The shift of certification from the state to private sector promoted by perceived deficiencies in Greek domestic institutional capacity facilitates the diffusion of ISO14001, albeit that it is seen more as a prerequisite of economic growth, rather than a significant force for environmental improvement. This thesis critically evaluates these trends and argues for environmental management engaging with competitiveness and market pressures. Indeed ISO14001 has become a "commodity" in the market for global credibility. With public infrastructure projects at least, state legislative action is important in mandating the use of such 'voluntary tools', raising further questions about the motivation. Market forces by themselves seem less able to undertake the required changes in environmental policy. It is shown that to facilitate environmental responsibility, proper institutional and cultural arrangements must be established and executed by the government and the wider society

Reconstructive periodontal therapy with simultaneous ridge augmentation. A clinical and histological case series report

Treatment of intrabony periodontal defects with a combination of a natural bone mineral (NBM) and guided tissue regeneration (GTR) has been shown to promote periodontal regeneration in intrabony defects. In certain clinical situations, the teeth presenting intrabony defects are located at close vicinity of the resorbed alveolar ridge. In these particular cases, it is of clinical interest to simultaneously reconstruct both the intrabony periodontal defect and the resorbed alveolar ridge, thus allowing insertion of endosseous dental implants. The aim of the present study was to present the clinical and histological results obtained with a new surgical technique designed to simultaneously reconstruct the intrabony defect and the adjacently located resorbed alveolar ridge. Eight patients with chronic advanced periodontitis displaying intrabony defects located in the close vicinity of resorbed alveolar ridges were consecutively enrolled in the study. After local anesthesia, mucoperiosteal flaps were raised, the granulation tissue removed, and the roots meticulously scaled and planed. A subepithelial connective tissue graft was harvested from the palate and sutured to the oral flap. The intrabony defect and the adjacent alveolar ridge were filled with a NBM and subsequently covered with a bioresorbable collagen membrane (GTR). At 11–20 months (mean, 13.9 ± 3.9 months) after surgery, implants were placed, core biopsies retrieved, and histologically evaluated. Mean pocket depth reduction measured 3.8 ± 1.7 mm and mean clinical attachment level gain 4.3 ± 2.2 mm, respectively. Reentry revealed in all cases a complete fill of the intrabony component and a mean additional vertical hard tissue gain of 1.8 ± 1.8 mm. The histologic evaluation indicated that most NBM particles were surrounded by bone. Mean new bone and mean graft area measured 17.8 ± 2.8% and 32.1 ± 8.3%, respectively. Within their limits, the present findings indicate that the described surgical approach may be successfully used in certain clinical cases to simultaneously treat intrabony defects and to reconstruct the resorbed alveolar ridge

The phosphorous necrosis of the jaws and what can we learn from the past: a comparison of "phossy" and "bisphossy" jaw

INTRODUCTION: The osteopathology of the jaws associated with bone resorption inhibitors is a current topic that engages a variety of clinical specialists. This has increased after the approval of denosumab for treatment of osteoporosis and skeletal-related events in patients with solid malignancy. Early after the first publications, there is a possible connection between phosphorous necrosis of the jaws, a dreadful industrial disease mentioned, and bisphosphonate-induced pathology. The nineteenth century was the prime time for phosphorus necrosis of match factory workers. RESULTS: This occurrence provides an interesting insight into the medical and surgical profession in the nineteenth century. There are striking parallels and repetition of current and old ideas in the approach to this "new disease." There are similar examples in case descriptions when compared with today's patients of bisphosphonate-related osteonecrosis of the jaws (BRONJ). DISCUSSION: Phosphorus necrosis was first described in Austria. Soon after this, surgeons in German-speaking countries including well-known clinicians Wegner (1872) and von Schulthess-Rechberg (1879) pioneered the analysis, preventative measures, and treatment of this disease. The tendency at this time was to approach BRONJ as a "special kind of osteomyelitis" in pretreated and metabolically different bone. Not only the treatment strategy to wait until sequestrum formation with subsequent removal and preventative measures but also the idea of focusing on the periosteum as the triggering anatomical structure may have been adopted from specialists in the nineteenth century. Therefore, phosphorous necrosis of the jaw is an excellent example of "learning from the past.

Towards the design of 3D multiscale instructive tissue engineering constructs: Current approaches and trends

The design of 3D constructs with adequate properties to instruct and guide cells both in vitro and in vivo is one of the major focuses of tissue engineering. Successful tissue regeneration depends on the favorable crosstalk between the supporting structure, the cells and the host tissue so that a balanced matrix production and degradation is achieved. Herein, the major occurring events and players in normal and regenerative tissue are overviewed. These have been inspiring the selection or synthesis of instructive cues to include into the 3D constructs. We further highlight the importance of a multiscale perception of the range of features that can be included on the biomimetic structures. Lastly, we focus on the current and developing tissue-engineering approaches for the preparation of such 3D constructs: top-down, bottom-up and integrative. Bottom-up and integrative approaches present a higher potential for the design of tissue engineering devices with multiscale features and higher biochemichal control than top-down strategies, and are the main focus of this review.The research leading to these results has received funding from the European Research Council grant agreement ERC-2012-ADG-20120216-321266 for the project ComplexiTE. Portuguese Foundation for Science and Technology is gratefully acknowledged for the fellowship of Sara M. Oliveira (SFRH/BD/70107/2010)

Ο ρόλος του ύφους της διακυβέρνησης, της θεσμικής ικανότητας, και της νομοθετικής νοοτροπίας στην υιοθέτηση του ISO14001: η περιπτωσιολογική μελέτη του Διεθνούς Αερολιμένα Αθηνών (ΑΙΑ)

This thesis examines the development of ISO14001 - an international environmental management standard - within the Greek context. Numerous organisations in Greece are adopting schemes for environmental management, but the analysis examines the processes of adopting and implementing ISO14001 in a single organisation, by examining in-depth an international airport's participation in ISO14001. The rationale for this approach is to understand the "diffusion" of a notionally global policy instrument, by investigating the way in which ISO14001 is implemented in particular national settings through the concepts of institutional capacity, regulatory culture and governance style. The social and institutional aspects of environmental management are crucial here: in any policy implementation situation, in spite of complex mechanisms seeking to deliver more sustainable activities, there are likely to be disputable outcomes in the implementation of the scheme. In particular this research illustrates the ambiguous nature of the institutionalisation process itself and of the uncertain power available to states and other bodies to implement ISO14001. The findings illuminate the balance of forces promoting ISO14001 in Greece, where multi-national companies and supply-chain pressure are being joined by assertive - if not always effective - state action. The research identifies possible tensions between government policies, business initiatives and the growth of voluntarism as a force for better environmental management in Greece. The shift of certification from the state to private sector promoted by perceived deficiencies in Greek domestic institutional capacity facilitates the diffusion of ISO14001, albeit that it is seen more as a prerequisite of economic growth, rather than a significant force for environmental improvement. This thesis critically evaluates these trends and argues for environmental management engaging with competitiveness and market pressures. Indeed ISO14001 has become a "commodity" in the market for global credibility. With public infrastructure projects at least, state legislative action is important in mandating the use of such 'voluntary tools', raising further questions about the motivation. Market forces by themselves seem less able to undertake the required changes in environmental policy. It is shown that to facilitate environmental responsibility, proper institutional and cultural arrangements must be established and executed by the government and the wider society.H διδακτορική διατριβή πραγματεύεται την κατανόηση της εξάπλωση της διεθνούς νόρμας και θεσμικών εργαλείων της Βιώσιμης Ανάπτυξης υπό το πρίσμα συγκεκριμένου εννοιολογικού τρίπτυχου: θεσμική ικανότητα, νομοθετική / κανονιστική νοοτροπία, ύφος διακυβέρνησης.Η υιοθέτηση και υλοποίηση πολιτικών περιβαλλοντικής διαχείρισης (πλαίσιο Βιώσιμης Ανάπτυξης), υπό τη μορφή διεθνών (κατά ISO14001) και Ευρωπαϊκών προτύπων Περιβαλλοντικής Διαχείρισης (κατά EMAS - Eco- Management and Audit Scheme), στην Ελλάδα σε σχέση με τις τάσεις του Εθνικού, Ευρωπαϊκού και Διεθνούς θεσμικού και κανονιστικού πλαισίου μελετάται.Αυτή η διδακτορική διατριβή μελετά σε βάθος την περίπτωση εφαρμογής του διεθνούς προτύπου Περιβαλλοντικής Διαχείρισης, ISO14001, στο Διεθνή Αερολιμένα Αθηνών «Ελευθέριος Βενιζέλος» με στόχο να εξετάσει πως πρότυπα περιβαλλοντικής διαχείρισης εξελίσσονται σε μια παγκόσμια αγορά καθώς και τις πιέσεις για την εφαρμογή τους σε εθνικό επίπεδο (Ελλάδα) και σε διάφορους τομείς. Μέσω της συγκεκριμένης περιγραφής της διαδικασίας υιοθέτησης και εφαρμογής σε ένα τεχνολογικά προηγμένο τομέα με παγκόσμια απήχηση εξετάζεται γενικότερα η επιρροή και επίπτωση των θεσμικών, επιχειρηματικών και περιβαλλοντικών παραγόντων κατά το εννοιολογικό πλαίσιο του τρίπτυχου: θεσμική ικανότητα, νομοθετική / κανονιστική νοοτροπία, ύφος διακυβέρνησης.http://orca.cf.ac.uk/55579

Primary Diffuse Large B-Cell Lymphoma of the Mandible: Case Report and Review of the Literature

In the oral cavity, extranodal non-Hodgkin's lymphoma can occur in the periapical region either in the maxilla or mandible. Also, it can mimic inflammatory lesions that arise around the teeth apices such as periapical granuloma, radicular cyst and osteomyelitis. Misdiagnosis of lymphomas in the jaws may reduce the chance of successful treatment and worsen the prognosis. Therefore, any growth of periapical tissue must be submitted for histopathological evaluation to avoid a delay in the diagnosis. We present a case of extranodal non-Hodgkin's lymphoma of a 53-year-old male in the right posterior mandible that was initially misdiagnosed as a reactive periapical lesion. This case illustrates the importance for both the pathologist and the clinician of considering malignant lesions such as lymphoma in the differential diagnosis of periapical radiolucency