Dendrimers as scaffolds for multifunctional reversible addition–fragmentation chain transfer agents: Syntheses and polymerization

The synthesis and characterization of novel first‐ and second‐generation true dendritic reversible addition–fragmentation chain transfer (RAFT) agents carrying 6 or 12 pendant 3‐benzylsulfanylthiocarbonylsulfanylpropionic acid RAFT end groups with Z‐group architecture based on 1,1,1‐hydroxyphenyl ethane and trimethylolpropane cores are described in detail. The multifunctional dendritic RAFT agents have been used to prepare star polymers of poly(butyl acrylate) (PBA) and polystyrene (PS) of narrow polydispersities (1.4 < polydispersity index < 1.1 for PBA and 1.5 < polydispersity index < 1.3 for PS) via bulk free‐radical polymerization at 60 °C. The novel dendrimer‐based multifunctional RAFT agents effect an efficient living polymerization process, as evidenced by the linear evolution of the number‐average molecular weight (M_n) with the monomer–polymer conversion, yielding star polymers with molecular weights of up to M_n = 160,000 g mol^?1 for PBA (based on a linear PBA calibration) and up to M_n = 70,000 g mol^?1 for PS (based on a linear PS calibration). A structural change in the chemical nature of the dendritic core (i.e., 1,1,1‐hydroxyphenyl ethane vs trimethylolpropane) has no influence on the observed molecular weight distributions. The star‐shaped structure of the generated polymers has been confirmed through the cleavage of the pendant arms off the core of the star‐shaped polymeric materials. © 2004 Wiley Periodicals, Inc. J Polym Sci Part A: Polym Chem 42: 5877–5890, 2004     

Multicyclic polyethers derived from 1,1,1‐tris(4‐hydroxyphenyl)ethane and 2,6‐dihalopyridines

Poly(pyridine ether)s were prepared in two ways: the polycondensation of silylated 1,1,1‐tris(4‐hydroxyphenyl)ethane (THPE) with 2,6‐difluoropyridine (method A) and the polycondensation of free THPE with 2,6‐dichloropyridine (method B). With method A, the THPE/difluoropyridine feed ratio was varied from 1.0:1.0 to 1.0:1.6. Cycles, bicycles, and multicycles were the main reaction products, and crosslinking was never observed. When ideal stoichiometry was used exclusively, multicycles free of functional groups were obtained. These multicycles were detectable in matrix‐assisted laser desorption/ionization time‐of‐flight (MALDI‐TOF) mass spectra up to B₃₈C₇₆ with a mass of approximately 32,000 Da. With method B, the reaction conditions were varied at a fixed feed ratio to achieve an optimum for the preparation of multicyclic polyethers, but because of the lower reactivity of 2,6‐dichloropyridine, a quantitative conversion was not achieved. The reaction products were characterized with MALDI‐TOF mass spectrometry, viscosity measurements, and size exclusion chromatography. © 2004 Wiley Periodicals, Inc. J Polym Sci Part A: Polym Chem 42: 5725–5735, 2004     

Thermoplastic poly(ester‐imide)s derived from anhydride‐terminated polyester prepolymer and diisocyanate

The phase‐separation behavior of thermoplastic poly(ester‐imide) [P(E‐I)] multiblock copolymers, (A‐B)_n, was investigated by a stepwise variation of the imide content. All the multiblock copolymers were synthesized by solution polycondensation with dimethylformamide as a solvent. P(E‐I)s were prepared with anhydride‐terminated polyester prepolymer and diisocyanates. Polyester prepolymers were prepared by the reaction of pyromellitic dianhydride and two different polyols [poly(tetramethylene oxide glycol) (PTMG) and polycaprolactone diol (PCL)]. Structural determination was done with Fourier transform infrared spectroscopy and Fourier transform NMR, and the molecular weight was determined by gel permeation chromatography. The effect of the imide content on the thermal properties of the synthesized P(E‐I)s was investigated by thermogravimetric analysis and differential scanning calorimetry. The polymers were also characterized for static and dynamic mechanical properties. Thermal analysis data indicated that the polymers based on PTMG were stable up to 330 °C in nitrogen atmosphere and exhibited phase‐separated morphology. Polymers based on PCL showed multistage decomposition, and the films derived from them were too fragile to be characterized for static and dynamic mechanical properties. © 2003 Wiley Periodicals, Inc. J Polym Sci Part A: Polym Chem 42: 341–350, 2004     

Understanding the quality concept in health care

During the past three decades there has been an intense debate on the quality of health care. Errors in medicine, practice variations, competence of physicians, scarcity and lack of resources have all been reasons for discussing the quality of care. A clear definition of quality should explain the nature of the debate, improve uniformity of speech and facilitate meaningful actions such as quality assurance or quality improvement. However, in due course many different definitions have been proposed and principles of quality assurance in health care have been frequently questioned, because of their industrial nature. It raises questions on our understanding of quality in health care. In this paper, we (i) explore the nature of the quality concept, (ii) explain its meaning by Wittgenstein's theory on rule-following, and (iii) argue for understanding medical care as a reflexive practice, in order to integrate the meaning of quality in medical care.