Social Exclusion in Later Life: A Systematic Review of the Literature

In the last decade, there has been a growing awareness regarding social exclusion. Considering the ageing population and the likelihood of older people being socially excluded, the aims of this article are to: (1) review existing studies concerning social exclusion in later life; and (2) identify how environmental and life-course perspectives are presented in studies focusing on social exclusion in later life. A systematic review in seven scientific databases was conducted to explore the peer-reviewed evidence. In total, 26 articles were included and analysed. Findings describe the variety of methods, conceptualisation, dimensions and measures used in this recent area of research. Determinants of social exclusion in later life are discussed and life-course and environmental perspectives are examined. The discussion highlights the complex character of the concept and measurement of social exclusion, and the presence of general and age-specific dimensions of social exclusion in later life. The time and context relativity and the need for life-course and environmental perspectives on social exclusion in later life are discussed. Finally, future directions of research are discussed.     

A homogenized constrained mixture model of restenosis and vascular remodelling after balloon angioplasty

Restenosis is one of the main adverse effects of the treatment of atherosclerosis through balloon angioplasty or stenting. During the intervention, the arterial wall is overstretched, causing a cascade of cellular events and subsequent neointima formation. This mechanical stimulus and its mechanobiological effects can be reproduced in biomechanical simulations. The aim of these models is to predict the long-term outcome of these procedures, to help increase the understanding of restenosis formation and to allow for in silico optimization of the treatment. We propose a predictive finite-element model of restenosis, using the homogenized constrained mixture modelling framework designed to model growth and remodelling in soft tissues. We compare the results with clinical observations in human coronary arteries and experimental findings in non-human primate models. We also explore the model’s clinical relevance by testing its response to different balloon loads and to the use of drug-eluting balloons. The comparison of the results with experimental data shows the relevance of the model. We show its ability to predict both inward and outward remodelling as observed in vivo and we show the importance of an improved understanding of restenosis formation from a biomechanical point of view.