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31.

Objective and method

The French Obesity Plan enabled the creation of 37 Specialized Obesity Centers (CSOs) in 2012 to ensure a dual mission, the multidisciplinary management of severe or complex obesity and the organization of care channels in the regions. This report takes stock of the first three years of operation of the CSOs, based on the data collected by the National Observatory of CSOs (oNCSO), set up by the General Directorate of Hospitalization and Care.

Results

The overall results were positive for access to paraclinical examinations, although all CSOs did not have a biphotonic absorptiometer (DEXA) or calorimetry. The CSOs were initially developing links with the 12 sectors of care studied by the oNCSO, with some weaknesses including psychiatry. The survey did not make it possible to take stock of the real numbers of the actual workforce of the CSOs, given the large number of outliers. All responding CSOs reported having obese-oriented therapeutic education programs for the medical, surgical, and pediatric sectors. The activities of CSOs in medicine, surgery, gynecology and obstetrics were heterogeneous. In 2014, about 25–30% of all bariatric surgery procedures were performed in the CSOs in France. On average, CSOs received about 2500 severely obese adult patients in day care or in-patient care for the medical sector. The results suggested a certain fragility of the pathways of obstetric gynecology and the pediatric pathways.

Conclusion

This declarative survey, despite many limitations, shows however that CSOs have taken an important place in the French care system.  相似文献   
32.
This study examines three potential contributions (i.e., additive only, hierarchical compensatory, and hierarchical conditional) of mentor support to youth academic adjustment, taking into account interactions with support from mothers and teachers. We derived data from a larger study of the Big Brothers Big Sisters (BBBS) of Canada community mentoring program. The sample included 427 youth (average age 9.8 years; 64% girls, 56% White) who received one-to-one community-based mentoring for at least three months. We assessed perceptions of support from mothers and teachers before the match and assessed perceptions of support from mentors five times throughout the mentoring experience. Hierarchical linear regression analyses showed that mentor support predicted positive changes in youth academic adjustment (i.e., school attitude, academic self-efficacy, assistance seeking, and problem solving) mainly when mentees already reported high support from their mother. This finding clearly supports the conditional model and invites researchers to question the assumption that mentoring constitutes a corrective experience for young people (i.e., the compensatory model). BBBS agencies are strongly encouraged to involve parents in the mentoring process and to view them as experts, assets, and allies in their effort to meet the youth’s needs.  相似文献   
33.
This study aimed to measure the active mandibular range of motion (ROM) (mouth opening: MO; right and left lateral movements: RL and LL; protrusion: P) in Brazilian children of both genders and of various ages, weights, and heights, and to establish correlations among such variables. Study subjects (n = 303) were healthy boys and girls, with ages ranging between 6 and 14 years, who were regular students of a public school in the state of S?o Paulo. Analysis of variance and intra-class correlation coefficients were considered significant for p < 0.05. Weak significant correlations were observed between mandibular ROM and age, height, and weight. No statistically significant differences (p > 0.05) were observed regarding mandibular ROM between gender groups. Mean mandibular ROM values showed significant increases (p < 0.05) in relation to age, height, and weight, except for RL (p > 0.05), in the studied age range. Significantly smaller (p < 0.05) mean mandibular ROM values were observed for the intervals of 6 and 7 years of age, 1.15-1.35 m, and 17.30-26.50 kg, in relation to the other ranges. Nonetheless, no differences were observed among mean mandibular ROM values in the ranges 8 to 12-14 years, 1.36-1.75 m, and 47-85 kg. Thus, it is suggested that weight, height, and age variables be considered when obtaining mandibular ROM values, particularly in children aged 6 to 7 years, measuring 1.15-1.35 m, and weighing between 17.3-46.5 kg.  相似文献   
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The use of the microscope as a tool for practising Medicine, especially in surgical specialisations, has been established for decades. The microscope was first used in OdontologyDentistry back to the 1970s and 1980s, and was introduced more widely (although it was still far from being in general use) during 1990s. The purpose of this article is to describe the main applications of the microscope in OdontologyDentistry today, as well as providing odontologists and stomatologists, whether specialists or in general practice, with information about microscopic OdontologyDentistry for better patient care. This work also gives particular importance to matters needed to achieve the necessary manual dexterity to work in a magnified operating field using a surgical microscope (SM).  相似文献   
36.
OBJECTIVE: To evaluate the likelihood of caries increment in schoolchildren, based on their prior caries experience. MATERIAL AND METHODS: We undertook a longitudinal study in 452 six-to-nine year olds between 1999 and 2001 in Mexico, with dental exams conducted by two standardized examiners (kappa>0.85). The dependent variable was the DMFT increment, dichotomized as without increment, and at least one unit of increment. Independent variables estimated caries experience at baseline. Data were analyzed using non-parametric tests and generalized linear models (log-binomial) to calculate relative risk (RR) adjusted for age and sex. RESULTS: The percentage of caries-free children diminished by 20.5% from 1999 to 2001. DMFT index increased two-fold, from 0.25+/-0.70 in 1999 to 0.77+/-1.30 in 2001 (p<0.001). The overall risk for this sample was 24%. The DMFT increment was higher (p<0.001) in children with DMFT>0 and dmft>0 in 1999 (RR=1.89, 95% CI=1.37-2.62; RR=2.71, 95% CI=1.94-3.76, respectively). The likelihood for DMFT increment from the 1999 levels was: (1) 2.78 times higher (95% CI=2.06-3.76) if schoolchildren had caries in any of the first permanent molars and (2) 1.62 times higher (95% CI=1.20-2.19) if schoolchildren were affected by high severity caries at baseline. CONCLUSIONS: Both caries prevalence and mean DMFT had significant increments in 18 months. Dental caries in the primary (dmft) and permanent (DMFT) dentitions at baseline are goods indicators of subsequent caries development in this group of children in a medium income country. This relationship became stronger when the occurrence of caries in the first permanent molars was included.  相似文献   
37.
Background: To our knowledge, prospective studies (matched for sex, smoking, and diabetes) that investigated the influence of compliance in the progression of periodontitis and tooth loss in periodontal maintenance therapy (PMT) programs were not previously reported. Methods: A total of 58 regular complier (RC) and 58 erratic complier (EC) individuals were recruited from a prospective cohort with 238 patients under PMT and matched by sex, diabetes, and smoking habits. A full‐mouth periodontal examination that included bleeding on probing (BOP), probing depths (PDs), clinical attachment levels, and number of teeth were determined at all PMT visits during a 3‐year interval. The influence of variables of interest was tested through multivariate logistic regression. Results: The progression of periodontitis and tooth loss was significantly lower among RC compared to EC patients. A higher progression of periodontitis was observed among EC patients who smoked. The final logistic model for the progression of periodontitis in the RC group included smoking (odds ratio [OR]: 4.2) and >30% of sites with BOP (OR: 2.8), and the final logistic model for the progression of periodontitis in the EC group included smoking (OR: 7.3), >30% of sites with BOP (OR: 3.2), PDs of 4 to 6 mm in 10% of sites (OR: 3.5), diabetes (OR: 1.9), and number of lost teeth (OR: 3.1). Conclusions: RC patients presented a lower progression of periodontitis and tooth loss compared to EC patients. This result highlighted the influence of the pattern of compliance in maintaining a good periodontal status. Moreover, important risk variables such as smoking and diabetes influenced the periodontal status and should be considered when determining the risk profile and interval time for PMT visits.  相似文献   
38.
This study evaluated the effect of the adhesive application mode and fiber post translucency on the push-out bond strength to dentin. Bovine roots were endodontically treated, and 10 roots were used for each adhesive application mode: PB (Prime&Bond 2.1), PB + SC (Self-cure activator), PB + SBM (Scotchbond Multi-purpose adhesive system), BB (Brush&Bond), BB + CAT (chemical catalyst), and BB + SBM. The translucent Light-Post and Aestheti-Post were cemented. The roots/cemented posts were transversally sectioned to originate three thirds (cervical, middle, and apical). The push-out test was performed, and the failure mode of fractured specimens was analyzed. There was no difference between the fiber posts. For PB and BB, the use of hydrophobic adhesive resin SBM increased post bond strength. The use of SC and CAT catalyst did not affect the push-out bond strength values. The apical third presented the lowest bond strengths.  相似文献   
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40.
OBJECTIVES: The purpose of this study was to measure and analyze the mechanical properties of several composite materials designed for dental restoration. METHODS: The materials were composed of a visible light-curing monomer mixture (either Bis-GMA+TEGDMA or Bis-GMA+HEMA) as a matrix and hydroxyapatite (either microscopic or nanoscopic particles) as a reinforcing filler. The surface of the hydroxyapatite particles was modified by using a coupling agent (citric, malic, acrylic or methacrylic acid). Five specimens of 14 different composites were prepared for each mechanical test: flexural strength, Young's modulus and Vickers hardness. Mean values and standard deviations were calculated, and ANOVA and Student Newman Keuls multiple comparison tests were applied (P < 0.05). RESULTS: The addition of 50-60 wt% of hydroxyapatite particles to the unfilled monomer mixtures led to the increase of both Young's modulus and surface hardness of the material, while the flexural strength decreased. In general, when microscopic instead of nanoscopic hydroxyapatite was used as a reinforcing filler, mechanical properties were favored. The mechanical properties were also improved by adding citric, acrylic or methacrylic acid as a coupling agent. CONCLUSIONS: An adequate surface modification of the hydroxyapatite particles conferred enhanced mechanical properties to the final dental composite. Microscopic-hydroxyapatite particles are preferred to nanoscopic ones.  相似文献   
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