Extensión Universitaria. Salud Bucal

La experiencia de Odontología Social III, de la Facultad de Odontología de Rosario se organiza a partir de la Extensión Universitaria. Esta, desarrolla en escuelas un programa de promoción de la salud, según la Estrategia de Atención Primaria de la Salud Bucal. La Extensión Universitaria es entendida como  la organización de un servicio a la comunidad sostenido en tiempo y espacio, retroalimentado con la comunidad misma en un intercambio de mutuo fortalecimiento. Académicamente se enmarca como docencia e investigación participativa (Menin 2001). A partir del año 1993, se comienzan a elaborar datos epidemiológicos en relación a salud bucal, esto permitió evaluar los procesos de salud-enfermedad relacionados con la caries dental y sus condiciones de riesgo en cada grupo, ordenados por grado y en cada escuela siguiendo los lineamientos de OPS en la construcción de indicadores y análisis de población según parámetros de severidad. En 1997, se incorporaron las TICs que facilitaron el análisis de datos con una mayor profundización y precisión construyéndose datos epidemiológicos por grado, por escuela y para el conjunto de la población participante. El objetivo de este trabajo es analizar el impacto del programa en las distintas escuelas en las que se desarrolla, en un período que va de 1997 a 2011. Se toman como indicadores los índices CPOD/S, ceod/s, observándose el perfil epidemiológico de los procesos de salud-enfermedad-atención. A su vez esta producción colectiva, que anualmente se actualiza, se constituye en un insumo indispensable en el marco curricular de la cátedra, ya que es incorporada como un contenido programático. En este sentido, los indicadores obtenidos se entienden como un punto de partida basal del proceso de construcción de conocimiento de la realidad, avanzándose en investigación de la situación contextual particular que permiten darle sentido a los datos. A su vez esta metodología permite reorientar las acciones futuras de todos los actores.  

INvolvement of breast CAncer patients during oncological consultations: a multicentre randomised controlled trial--the INCA study protocol.

INTRODUCTION: Studies on patient involvement show that physicians make few attempts to involve their patients who ask few questions if not facilitated. On the other hand, the patients who participate in the decision-making process show greater treatment adherence and have better health outcomes. Different methods to encourage the active participation during oncological consultation have been described; however, similar studies in Italy are lacking. The aims of the present study are to (1) assess the effects of a preconsultation intervention to increase the involvement of breast cancer patients during the consultation, and (2) explore the role of the attending companions in the information exchange during consultation. METHODS AND ANALYSIS: All female patients with breast cancer who attend the Oncology Out-patient Services for the first time will provide an informed consent to participate in the study. They are randomly assigned to the intervention or to the control group. The intervention consists of the presentation of a list of relevant illness-related questions, called a question prompt sheet. The primary outcome measure of the efficacy of the intervention is the number of questions asked by patients during the consultation. Secondary outcomes are the involvement of the patient by the oncologist; the patient's perceived achievement of her information needs; the patient's satisfaction and ability to cope; the quality of the doctor-patient relationship in terms of patient-centeredness; and the number of questions asked by the patient's companions and their involvement during the consultation. All outcome measures are supposed to significantly increase in the intervention group. ETHICS AND DISSEMINATION: The study was approved by the local Ethics Committee of the Hospital Trust of Verona. Study findings will be disseminated through peer-reviewed publications and conference presentations. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT01510964

Challenges in Complex Systems Science

FuturICT foundations are social science, complex systems science, and ICT. The main concerns and challenges in the science of complex systems in the context of FuturICT are laid out in this paper with special emphasis on the Complex Systems route to Social Sciences. This include complex systems having: many heterogeneous interacting parts; multiple scales; complicated transition laws; unexpected or unpredicted emergence; sensitive dependence on initial conditions; path-dependent dynamics; networked hierarchical connectivities; interaction of autonomous agents; self-organisation; non-equilibrium dynamics; combinatorial explosion; adaptivity to changing environments; co-evolving subsystems; ill-defined boundaries; and multilevel dynamics. In this context, science is seen as the process of abstracting the dynamics of systems from data. This presents many challenges including: data gathering by large-scale experiment, participatory sensing and social computation, managing huge distributed dynamic and heterogeneous databases; moving from data to dynamical models, going beyond correlations to cause-effect relationships, understanding the relationship between simple and comprehensive models with appropriate choices of variables, ensemble modeling and data assimilation, modeling systems of systems of systems with many levels between micro and macro; and formulating new approaches to prediction, forecasting, and risk, especially in systems that can reflect on and change their behaviour in response to predictions, and systems whose apparently predictable behaviour is disrupted by apparently unpredictable rare or extreme events. These challenges are part of the FuturICT agenda

Integration of palliative care into standard oncology care: American society of clinical oncology clinical practice guideline update

Purpose To provide evidence-based recommendations to oncology clinicians, patients, family and friend caregivers, and palliative care specialists to update the 2012 American Society of Clinical Oncology (ASCO) provisional clinical opinion (PCO) on the integration of palliative care into standard oncology care for all patients diagnosed with cancer. Methods ASCO convened an Expert Panel of members of the ASCO Ad Hoc Palliative Care Expert Panel to develop an update. The 2012 PCO was based on a review of a randomized controlled trial (RCT) by the National Cancer Institute Physicians Data Query and additional trials. The panel conducted an updated systematic review seeking randomized clinical trials, systematic reviews, and metaanalyses, as well as secondary analyses of RCTs in the 2012 PCO, published from March 2010 to January 2016. Results The guideline update reflects changes in evidence since the previous guideline. Nine RCTs, one quasiexperimental trial, and five secondary analyses from RCTs in the 2012 PCO on providing palliative care services to patients with cancer and/or their caregivers, including family caregivers, were found to inform the update. Recommendations Inpatients and outpatients with advanced cancer should receive dedicated palliative care services, early in the disease course, concurrent with active treatment. Referral of patients to interdisciplinary palliative care teams is optimal, and services may complement existing programs. Providers may refer family and friend caregivers of patients with early or advanced cancer to palliative care services

Fertility, Living Arrangements, Care and Mobility

There are four main interconnecting themes around which the contributions in this book are based. This introductory chapter aims to establish the broad context for the chapters that follow by discussing each of the themes. It does so by setting these themes within the overarching demographic challenge of the twenty-first century – demographic ageing. Each chapter is introduced in the context of the specific theme to which it primarily relates and there is a summary of the data sets used by the contributors to illustrate the wide range of cross-sectional and longitudinal data analysed

Magnetic, orbital and charge ordering in the electron-doped manganites

The three dimensional perovskite manganites in the range of hole-doping $x > 0.5$ are studied in detail using a double exchange model with degenerate $e_g$ orbitals including intra- and inter-orbital correlations and near-neighbour Coulomb repulsion. We show that such a model captures the observed phase diagram and orbital-ordering in the intermediate to large band-width regime. It is argued that the Jahn-Teller effect, considered to be crucial for the region $x<0.5$, does not play a major role in this region, particularly for systems with moderate to large band-width. The anisotropic hopping across the degenerate $e_g$ orbitals are crucial in understanding the ground state phases of this region, an observation emphasized earlier by Brink and Khomskii. Based on calculations using a realistic limit of finite Hund's coupling, we show that the inclusion of interactions stabilizes th e C-phase, the antiferromagnetic metallic A-phase moves closer to $x=0.5$ while th e ferromagnetic phase shrinks in agreement with recent observations. The charge ordering close to $x=0.5$ and the effect of reduction of band-width are also outlined. The effect of disorder and the possibility of inhomogeneous mixture of competing states have been discussed.Comment: 42 pages, 16 figure

Search for direct production of charginos and neutralinos in events with three leptons and missing transverse momentum in √s = 7 TeV pp collisions with the ATLAS detector

A search for the direct production of charginos and neutralinos in final states with three electrons or muons and missing transverse momentum is presented. The analysis is based on 4.7 fb−1 of proton–proton collision data delivered by the Large Hadron Collider and recorded with the ATLAS detector. Observations are consistent with Standard Model expectations in three signal regions that are either depleted or enriched in Z-boson decays. Upper limits at 95% confidence level are set in R-parity conserving phenomenological minimal supersymmetric models and in simplified models, significantly extending previous results

Jet size dependence of single jet suppression in lead-lead collisions at sqrt(s(NN)) = 2.76 TeV with the ATLAS detector at the LHC

Measurements of inclusive jet suppression in heavy ion collisions at the LHC provide direct sensitivity to the physics of jet quenching. In a sample of lead-lead collisions at sqrt(s) = 2.76 TeV corresponding to an integrated luminosity of approximately 7 inverse microbarns, ATLAS has measured jets with a calorimeter over the pseudorapidity interval |eta| < 2.1 and over the transverse momentum range 38 < pT < 210 GeV. Jets were reconstructed using the anti-kt algorithm with values for the distance parameter that determines the nominal jet radius of R = 0.2, 0.3, 0.4 and 0.5. The centrality dependence of the jet yield is characterized by the jet "central-to-peripheral ratio," Rcp. Jet production is found to be suppressed by approximately a factor of two in the 10% most central collisions relative to peripheral collisions. Rcp varies smoothly with centrality as characterized by the number of participating nucleons. The observed suppression is only weakly dependent on jet radius and transverse momentum. These results provide the first direct measurement of inclusive jet suppression in heavy ion collisions and complement previous measurements of dijet transverse energy imbalance at the LHC.Comment: 15 pages plus author list (30 pages total), 8 figures, 2 tables, submitted to Physics Letters B. All figures including auxiliary figures are available at http://atlas.web.cern.ch/Atlas/GROUPS/PHYSICS/PAPERS/HION-2011-02