Office of the Chief Information Officer FY2014 IOWAccess Revolving Fund Annual Report, January 2015

This report highlights the Fiscal Year 2014 accomplishments of IOWAccess, including IOWAccess projects in development. Certain services offered through IOWAccess charge a value-added fee. Contained within this report are a description of the IOWAccess business model and the processes employed by IOWAccess to fund and monitor projects, along with a listing of projects funded during the reporting period.

Alegria o patiment?

Imaginem que veiem una instantània de la cara de dos polítics, caps dels seus respectius grups parlamentaris, just després d'una votació decisiva en què han defensat postures contraposades, però no sabem quina de les dues alternatives ha estat l'escollida per la majoria del Parlament. Ho podríem deduir pels seus rostres?

Reflexions dels estudiants respecte al seu aprenentatge en el Centres d’Atenció Primària

En el marco del Espacio Europeo de Enseñanza Superior y dentro de los estudios de Grado de Enfermería, la importancia de las prácticas radica en que el alumno pueda situar los aprendizajes teóricos dentro de un marco real; así mismo se fomenta el análisis crítico dentro del ámbito de actuación. Durante la realización de las prácticas clínicas en los CAPs se pide al alumnado que haga por escrito una reflexión de su aprendizaje. El aprendizaje reflexivo pretende que el estudiante tome conciencia de su propio proceso de aprendizaje y mantenga un compromiso activo con su formación para mejorar la adquisición de sus habilidades profesiona-les.

Does a mandatory telemedicine call prior to visiting a physician reduce costs or simply attract good risks?

This paper aims to estimate empirically the efficiency of a Swiss telemedicine service introduced in 2003. We used claims' data gathered by a major Swiss health insurer, over a period of 6 years and involving 160 000 insured adults. In Switzerland, health insurance is mandatory, but everyone has the option of choosing between a managed care plan and a fee-for-service plan. This paper focuses on a conventional fee-for-service plan including a mandatory access to a telemedicine service; the insured are obliged to phone this medical call centre before visiting a physician. This type of plan generates much lower average health expenditures than a conventional insurance plan. Reasons for this may include selection, incentive effects or efficiency. In our sample, about 90% of the difference in health expenditure can be explained by selection and incentive effects. The remaining 10% of savings due to the efficiency of the telemedicine service amount to about SFr 150 per year per insured, of which approximately 60% is saved by the insurer and 40% by the insured. Although the efficiency effect is greater than the cost of the plan, the big winners are the insured who not only save monetary and non-monetary costs but also benefit from reduced premiums. Copyright © 2010 John Wiley & Sons, Ltd.

Seleção assistida com uso de marcador molecular para resistência a potyvírus em pimentão

O objetivo deste trabalho foi determinar a presença do alelo Pvr4, que confere resistência contra o PepYMV (Pepper yellow mosaic virus), em genótipos de pimentão comunmente encontrados no mercado brasileiro, com uso de um marcador molecular codominante tipo CAPS. A resistência ao PepYMV, nos genótipos CM-334-INRA, Myr-29 e em genótipos derivados do híbrido comercial Mônica-R, foi detectada como associada à banda de 444 pb, ligada ao alelo de resistência Pvr4. As plantas resistentes homozigotas (pvr4/pvr4) mostraram uma banda de 444 pb, as suscetíveis (Pvr4+/Pvr4+) uma banda de 458 pb e as resistentes heterozigotas (Pvr4+/Pvr4) mostraram as duas bandas. No entanto, no acesso resistente CM-334-UFV, nos híbridos Magali-R e Martha-R, assim como em populações derivadas desse acesso e desses híbridos, a resistência ao PepYMV não esteve associada ao marcador CAPS. O acesso CM-334-UFV ('Criollo de Morelos-334', de Viçosa, MG) distinguiu-se do CM-334-INRA ('Criollo de Morelos-334', da França); embora ambos os acessos tenham sido resistentes ao PepYMV, apenas em CM-334-INRA foi encontrada a associação da resistência com a banda de 444 pb.

The structure and development of Russia's food retail sector from the point of view of Finnish food industry

Tämän diplomityön tavoitteena on selvittää Venäjän ruoan vähittäiskaupan rakenne ja sen tuleva kehitys. Tällä hetkellä se on yksi maailman nopeimmin kasvavista markkinoista. Kasvun syynä on korkea öljyn hinta, jokaon kumuloitunut ihmisten palkkoihin. Kuitenkin vaikka tulot kasvavat, ruokaan käytetty osuus tuloista on pysynyt suhteellisen vakaana. Kulutus on siis siirtymässä laadukkaampiin ja arvokkaampiin tuotteisiin Modernien kauppojen osuus markkinoista on vielä pieni, koska Venäjän vähittäiskauppasektori on yhä hajaantunut perinteisiin kauppaformaatteihin kuten kioskeihin, toreille ja pieniin ruokakauppoihin. Kauppaketjut ovat kuitenkin tulossa merkittävämmiksi. Suurin markkina-alue vähittäiskauppiaille on Moskova, mutta tällä hetkellä ketjut laajentavat toimintojaan nopeasti myös muille Venäjän alueille. Parhaat kasvunäkymät ovat alueilla, vaikka Moskovan markkinat eivät olekaan kyllästyneet. Tärkein kasvua rajoittava tekijä Moskovassa on rakennustonttien ja kiinteistöjen saatavuus. Vähittäiskauppamarkkinat lähestyvät kyllästymispistettä, josta seuraa markkinoiden konsolidaatio. Tämä prosessi on jo alkanut, mutta kovin paljon yritysostoja ei ole vielätehty. Toistaiseksi kauppaketjut ovat tyytyneet muodostamaan alliansseja. Ketjut pyrkivät parantamaan asemaansa hintaneuvotteluissa muodostamalla osto-alliansseja, luomalla omia brändejä ja käyttämällä alueellista laajentumista lyömäaseena. Jotta ruoan tuottaja pääsisi myös alueellisille markkinoille, on sen ehkä suostuttava myymään tuotteitaan edullisempaan hintaan. Tavarantoimittajat ovat vahvassa asemassa silloin, kun heillä on toimiva jakeluverkko, kyky JIT-toimituksiin,kunnollinen dokumentaatiokäytäntö, vahva brändi ja edullinen hinta. Ns. listausmaksun suuruus voi määrittää tuottajan tuotteilleen saaman hyllytilan koon.

Detección Precoz de los factores de riesgo cardiovasculares en los Centros de Atención Primaria de Cataluña Central

Las enfermedades cardiovasculares son actualmente la principal causa de muerte prematura, por lo que es necesario controlar los factores que podrían reducir el riesgo cardiovascular. El presente estudio se centra en la ejecución de los protocolos de prevención cardiovascular en los Centros de Atención Primaria de Cataluña central, ya que se cree que una prevención adecuada podría reducir significativamente la mortalidad por esta enfermedad. Para lograr este objetivo, se propone utilizar una muestra poblacional de 100 individuos entre 45 y 65 años y realizar un estudio cuantitativo descriptivo. Basándose éste, en el control de las diferentes variables que afectan en poseer factores de riesgo cardiovascular: el alcohol, el tabaco, la obesidad, la inactividad física, la diabetes y el colesterol.

Russia's food retail sector from the point of view of Finnish food producers

This research paper focuses on the Russian food retail sector and its structure and development. At the momentit is one of the fastest growing markets today with 12.1% growth last year (2004). The growth originates from high oil price, which has been accumulated to people's wages. They are growing nominally more than 20% annually. But even though the income increases, the share of food of all retailtrade has been fairly stable with only a slight decline. Thus, the consumption is shifting to products with more quality and value. The shareof modern retail outlets is low, as the Russian retail sector is still very dispersed to traditional retail outlets such as kiosks, open markets and small grocery stores. The store chains are, however, becoming more and more significant. The biggest market for retailers is Moscow but nowadays the chains are expanding rapidly into other regions. Even though the markets have not been saturated in Moscow, the best prospects for growth are in the regions. The most important factor restricting the growth in Moscowis the availability of real estate and land plots for stores. The market is moving forward to saturation, and a consolidation process will follow. In fact, it has already started but not many acquisitions have been made so far. To this point the domestic chains have settled to form only alliances. The foreign players will be very strong in the tightening competition in the future. The problem of domestic chains is that the stores are nonstandardized, which is not cost-efficient. The chains are trying to enhance their power in price negotiations by forming purchasing alliances, introducing private label goods and using the regional expansion as a striking weapon. In order to follow the growing chains to other regions the producer must sell its products to the chains at favorable terms. Suppliers are strong in negotiations when they have a functioning distribution network, ability to JIT deliveries, proper documentationpolicies, a strong brand, reliability in deliveries and a fair price. The size of the entry ticket, i.e. the listing fee may define the shelf space a producer gets in the stores.

Evidence-based provisional clinical classification criteria for autoinflammatory periodic fevers.

The objective of this work was to develop and validate a set of clinical criteria for the classification of patients affected by periodic fevers. Patients with inherited periodic fevers (familial Mediterranean fever (FMF); mevalonate kinase deficiency (MKD); tumour necrosis factor receptor-associated periodic fever syndrome (TRAPS); cryopyrin-associated periodic syndromes (CAPS)) enrolled in the Eurofever Registry up until March 2013 were evaluated. Patients with periodic fever, aphthosis, pharyngitis and adenitis (PFAPA) syndrome were used as negative controls. For each genetic disease, patients were considered to be 'gold standard' on the basis of the presence of a confirmatory genetic analysis. Clinical criteria were formulated on the basis of univariate and multivariate analysis in an initial group of patients (training set) and validated in an independent set of patients (validation set). A total of 1215 consecutive patients with periodic fevers were identified, and 518 gold standard patients (291 FMF, 74 MKD, 86 TRAPS, 67 CAPS) and 199 patients with PFAPA as disease controls were evaluated. The univariate and multivariate analyses identified a number of clinical variables that correlated independently with each disease, and four provisional classification scores were created. Cut-off values of the classification scores were chosen using receiver operating characteristic curve analysis as those giving the highest sensitivity and specificity. The classification scores were then tested in an independent set of patients (validation set) with an area under the curve of 0.98 for FMF, 0.95 for TRAPS, 0.96 for MKD, and 0.99 for CAPS. In conclusion, evidence-based provisional clinical criteria with high sensitivity and specificity for the clinical classification of patients with inherited periodic fevers have been developed.

Health care usage among immigrants and native-born elderly populations in eleven European countries: results from SHARE

Differences in health care utilization of immigrants 50 years of age and older relative to the native-born populations in eleven European countries are investigated. Negative binomial and zero-inflated Poisson regression are used to examine differences between immigrants and native-borns in number of doctor visits, visits to general practitioners, and hospital stays using the 2004 Survey of Health, Ageing, and Retirement in Europe database. In the pooled European sample and in some individual countries, older immigrants use from 13 to 20% more health services than native-borns after demographic characteristics are controlled. After controlling for the need for health care, differences between immigrants and native-borns in the use of physicians, but not hospitals, are reduced by about half. These are not changed much with the incorporation of indicators of socioeconomic status and extra insurance coverage. Higher country-level relative expenditures on health, paying physicians a fee-for-service, and physician density are associated with higher usage of physician services among immigrants.

Venäjän ruoan vähittäiskauppasektorin rakenne ja kehitys suomalaisen elintarviketeollisuuden näkökulmasta

This research paper focuses on the Russian food retail sector and its structure and development. At the moment it is one of the fastest growing markets today. The growth originates from high oil price, which has been accumulated to people’s wages. But even though the income increases, the share of food of all retail trade has been fairly stable. Thus, the consumption is shifting to products with more quality and value. The share of modern retail outlets is low, as the Russian retail sector is still very dispersed to traditional retail outlets such as kiosks, open markets and small grocery stores. The store chains are, however, becoming more and more significant. The biggest market for retailers is Moscow but nowadays the chains are expanding rapidly into the other regions. Even though the markets have not been saturated in Moscow, the best prospects for growth are in the regions. The most important factor restricting the growth in Moscow is the availability of real estate and land plots for stores. The market is moving forward to saturation, and a consolidation process will follow. This process has already started but not many acquisitions have been made so far. To this point the domestic chains have settled to form alliances. The chains are trying to enhance their power in price negotiations by forming purchasing alliances, introducing private label goods and using the regional expansion as a striking weapon. In order to follow the growing chains to other regions the producer must sell its products to the chains at favorable terms. Suppliers are strong in negotiations when they have a functioning distribution network, ability to JIT-deliveries, proper documentation policies, a strong brand, reliability in deliveries and a fair price. The size of the entry ticket, i.e. the listing fee may define the shelf space a producer gets in the stores.

Availability, Cost or Culture ? : Obstacles to Childcare Services for Low-Income Families

Recent research has highlighted the existence of a social bias in the extent to which children have access to childcare. In general, children living in higher income households are more likely to be cared for in childcare centres. While the existence of a social bias in access to childcare services has been clearly demonstrated, we currently lack a clear explanation as to why this is the case. This paper uses a unique dataset based on survey data collected specifically to study patterns of childcare use in the Swiss canton of Vaud (N = 875). The paper exploits the variation in the way childcare is organised within the canton. Childcare is a municipal policy, as a result of which there are twenty-nine different systems in operation. Fees are progressive everywhere, but variation is substantial. Availability is also very different. This peculiar institutional setup provides an ideal situation to examine the determinants of childcare use by different income groups. Our findings suggest that differences in the fees charged to low-income households, as well as the degree of progressivity of the fee structure, are significant predictors of use, while availability seems to matter less.

Tilintarkastajan palkkiot osana riippumattomuussääntelyä

Tutkimuksen tavoitteena on selvittää, millä eri tavoin tilintarkastajan palkkiot voivat vaarantaa tilintarkastajan riippumattomuuden sekä minkälaisen uhan eri tilanteet riippumattomuudelle aiheuttavat. Tavoitteisiin pyritään teoriaosuuden käsiteanalyyttisen tutkimusmetodologian sekä rahoituslaitosten yritystutkijoille suunnatun empiirisen kyselytutkimuksen avulla. Sidosryhmien odotukset eivät aina vastaa säännöksiä tai tilintarkastuskäytäntöä. Palkkioriippuvuutta yhdestä asiakkaasta sekä palkkion riippumista työn tuloksista pidetään uhkina riippumattomuudelle. Tilanneharkintaa on käytettävä, kun tarjotaan muita palveluja tarkastusasiakkaille. Sisäistä tarkastusta sekä konsultointia pidetään usein uhkina riippumattomuudelle. Epätavallisista eduista ja lahjoista tulee kieltäytyä, kun ne liittyvät tilintarkastukseen. Tilintarkastajan oma vakavaraisuus on riippumattomuden kannalta olennaista. Tilintarkastajan valitsevat usein samat henkilöt, joita tarkastetaan. Tätä pidetään riippumattomuuden kannalta hankalana. Tilintarkastajan omaa moraalia ja etiikkaa sekä tilintarkastajiin kohdistuvaa valvontaa pidetään tehokkaimpina keinoina riippumattomuuden turvaamiseksi.

Gold or green: the debate on Open Access policies

The movement for open access to science seeks to achieve unrestricted and free access to academic publications on the Internet. To this end, two mechanisms have been established: the gold road, in which scientific journals are openly accessible, and the green road, in which publications are self-archived in repositories. The publication of the Finch Report in 2012, advocating exclusively the adoption of the gold road, generated a debate as to whether either of the two options should be prioritized. The recommendations of the Finch Report stirred controversy among academicians specialized in open access issues, who felt that the role played by repositories was not adequately considered and because the green road places the burden of publishing costs basically on authors. The Finch Report"s conclusions are compatible with the characteristics of science communication in the UK and they could surely also be applied to the (few) countries with a powerful publishing industry and substantial research funding. In Spain, both the current national legislation and the existing rules at universities largely advocate the green road. This is directly related to the structure of scientific communication in Spain, where many journals have little commercial significance, the system of charging a fee to authors has not been adopted, and there is a good repository infrastructure. As for open access policies, the performance of the scientific communication system in each country should be carefully analyzed to determine the most suitable open access strategy. [Int Microbiol 2013; 16(3):199-203]

Phenotypic and genotypic characteristics of cryopyrin-associated periodic syndrome: a series of 136 patients from the Eurofever Registry.

OBJECTIVE: To evaluate genetic, demographic and clinical features in patients with cryopyrin-associated periodic syndrome (CAPS) from the Eurofever Registry, with a focus on genotype-phenotype correlations and predictive disease severity markers. METHODS: A web-based registry retrospectively collected data on patients with CAPS. Experts in the disease independently validated all cases. Patients carrying NLRP3 variants and germline-mutation-negative patients were included. RESULTS: 136 patients were analysed. The median age at disease onset was 9 months, and the median duration of follow-up was 15 years. Skin rash, musculoskeletal involvement and fever were the most prevalent features. Neurological involvement (including severe complications) was noted in 40% and 12% of the patients, respectively, with ophthalmological involvement in 71%, and neurosensory hearing loss in 42%. 133 patients carried a heterozygous, germline mutation, and 3 patients were mutation-negative (despite complete NLRP3 gene screening). Thirty-one different NLRP3 mutations were recorded; 7 accounted for 78% of the patients, whereas 24 rare variants were found in 27 cases. The latter were significantly associated with early disease onset, neurological complications (including severe complications) and severe musculoskeletal involvement. The T348M variant was associated with early disease onset, chronic course and hearing loss. Neurological involvement was less strongly associated with V198M, E311 K and A439 V alleles. Early onset was predictive of severe neurological complications and hearing loss. CONCLUSIONS: Patients carrying rare NLRP3 variants are at risk of severe CAPS; onset before the age of 6 months is associated with more severe neurological involvement and hearing loss. These findings may have an impact on treatment decisions.