Estimation of lung cancer diagnosis and treatment costs based on a patient-level analysis in Catalonia (Spain)

Background: Assessing of the costs of treating disease is necessary to demonstrate cost-effectiveness and to estimate the budget impact of new interventions and therapeutic innovations. However, there are few comprehensive studies on resource use and costs associated with lung cancer patients in clinical practice in Spain or internationally. The aim of this paper was to assess the hospital cost associated with lung cancer diagnosis and treatment by histology, type of cost and stage at diagnosis in the Spanish National Health Service. Methods: A retrospective, descriptive analysis on resource use and a direct medical cost analysis were performed. Resource utilisation data were collected by means of patient files from nine teaching hospitals. From a hospital budget impact perspective, the aggregate and mean costs per patient were calculated over the first three years following diagnosis or up to death. Both aggregate and mean costs per patient were analysed by histology, stage at diagnosis and cost type. Results: A total of 232 cases of lung cancer were analysed, of which 74.1% corresponded to non-small cell lung cancer (NSCLC) and 11.2% to small cell lung cancer (SCLC); 14.7% had no cytohistologic confirmation. The mean cost per patient in NSCLC ranged from 13,218 Euros in Stage III to 16,120 Euros in Stage II. The main cost components were chemotherapy (29.5%) and surgery (22.8%). Advanced disease stages were associated with a decrease in the relative weight of surgical and inpatient care costs but an increase in chemotherapy costs. In SCLC patients, the mean cost per patient was 15,418 Euros for limited disease and 12,482 Euros for extensive disease. The main cost components were chemotherapy (36.1%) and other inpatient costs (28.7%). In both groups, the Kruskall-Wallis test did not show statistically significant differences in mean cost per patient between stages. Conclusions: This study provides the costs of lung cancer treatment based on patient file reviews, with chemotherapy and surgery accounting for the major components of costs. This cost analysis is a baseline study that will provide a useful source of information for future studies on cost-effectiveness and on the budget impact of different therapeutic innovations in Spain.

Lyssnande : en vårdvetenskaplig betraktelse

Denna vårdvetenskapliga studie har sökarljuset riktat mot lyssnande som något fundamentalt för människan. Studiens syfte är att utifrån forskarens traditionstillhörighet och en klart uttalad teorikärna, värdegrund, ontologisk grund samt en hermeneutisk ansats avtäcka nytt inseende om vad lyssnande är samt vad som är vårdande i lyssnande. Studiens avsikt är att bringa ontologisk klarhet, klargöra lyssnandets plats inom vårdvetenskaplig teoribildning samt bidra med bilder av det vårdande med relevans för klinisk praxis. Det hermeneutiska arbetssättet är en ständig rörelse mellan det enskilda och gemensamma. Den vårdvetenskapliga traditionens grundläggande ordning utgör siktet för kunskapssökandet samtidigt som det är gentemot den caritativa vårdteorin som nytt inseende ur historiska källor reflekteras för att lysa upp och synliggöra det evidenta och ursprungliga om lyssnande. Begreppsutredningen av lyssna som begrepp ger förståelse för begreppets historiska ursprung och dess starka band med begreppen lyss, lystra, lyda, följa, iaktta, se samt lust, begär, böjelse och glädje. Läsning och begrundan av filosoferna Bubers, Lévinas och författaren Dostojevskijs livsverk avtäcker vittnesbörd och stillbilder som tolkas för att synliggöra tolkningsantaganden om lyssnandets väsen och gestaltning. Jag har läst och begrundat texterna med öppenhet, lyhördhet och en kvardröjande hållning för att låta dem beröra, tilltala mig och framträda som något nytt. Ur de enskilda texterna avtäcks mönster av en gemensam inre ordning och en gemensam stillbild och tolkningsantaganden om lyssnande formas. När den gemensamma inre ordningen får sammanstråla med studiens vårdvetenskapliga grund synliggörs en urbild och teser om lyssnande samt det vårdande i lyssnande. Avtäckandet visar att lyssnande är en grundhållning till livet självt. Människan lyssnar till sitt innersta väsen för att tillägna sig en inre grundordning samt hörsamma sin tillhörighet i en mera allomfattande gemenskap till den skapande, den andre och det oändliga. I ljuset av kärlekens kraft och bejakandet av mänskligt lidande kan ensamhet och gemenskap sluta förbund med varandra i en mellanverklighet som bär oändlighetens och evighetens kännetecken, och som får toner av det heliga och eviga att ljuda i allt och alla i en närvaro här och nu. Lyssnande är en väsenshandling som uttalas genom en vårdande hållning att tjäna, offra och bära ansvar för den andre med medmänsklig barmhärtighet och medmänskligt medlidande. Band till den andre knyts genom den egna sårbarheten och genom att med ödmjukhet, äkthet och gästfrihet bjuda in och välkomna den andre i sin annanhet. Den vårdande gemenskapen skapar en rörelse som bär på en livsbringande kraft genom vilken människan uppnår frihet att varda, finna näring och försoning.

Effectiveness of Pilotage

The objective of the pilotage effectiveness study was to come up with a process descrip-tion of the pilotage procedure, to design performance indicators based on this process description, to be used by Finnpilot, and to work out a preliminary plan for the imple-mentation of the indicators within the Finnpilot organisation. The theoretical aspects of pilotage as well as the guidelines and standards used were determined through a literature review. Based on the literature review, a process flow model with the following phases was created: the planning of pilotage, the start of pilo-tage, the act of pilotage, the end of pilotage and the closing of pilotage. The model based on the literature review was tested through interviews and observation of pilotage. At the same time an e-mail survey directed at foreign pilotage organisations, which included a questionnaire concerning their standards and management systems, operations procedures, measurement tools and their attitude to the passage planning, was conducted. The main issues in the observations and interviews were the passage plan and the bridge team co-operation. The phases of the pilotage process model emerged in both the pilotage activities and the interviews whereas bridge team co-operation was relatively marginal. Most of the pilotage organisations, who responded to the query, also use some standard-based management system. All organisations who answered the survey use some sort of a pilotage process model. According to the query, the main measuring tools for pilotage are statistical information concerning pilotage and the organisations, the customer feedback surveys, and financial results. Attitudes to-wards passage planning were mostly positive among the organisations. A workshop with pilotage experts was arranged where the process model constructed on the basis of the literature review was tuned to match practical pilotage. In the workshop it was determined that certain phases and the corresponding tasks, through which pilo-tage can be described as a process, were identifiable in all pilotage. The result of the workshop was a complemented process model, which separates incoming and outgoing traffic, as well as the fairway pilotage and harbour pilotage from each other. Addition-ally indicators divided according to the data gathering method were defined. Data con-cerning safety and traffic flow is gathered in the form of customer feedback. The pilot's own perceptions of the pilotage process are gathered through self-assessment. The measurement data which is connected to the phases of the pilotage process is generated e.g. by gathering statistics of the success of the pilot dispatches, the accuracy of the pi-lotage and the incidents that occurred during the pilotage, near misses, deviations and accidents. The measurement data is collected via the PilotWeb at the closing of the pilo-tage. A separate project and a project group with pilots also participating will be established for the deployment of the performance indicators. The phases of the project are: the definition phase, the implementation phase and the deployment phase. The purpose of the definition phase is to prepare questions for ship commanders concerning the cus-tomer feedback questionnaire and also to work out the self-assessment queries and the queries concerning the process indicators.

Strategisten muutosohjelmien tehostaminen IT-yrityksessä tietojohtamisen keinoilla

Tutkimusten mukaan suurin osa strategisista muutoshankkeista epäonnistuu. Tässä diplomityössä selvitettiin syitä epäonnistumisiin sekä kartoitettiin mahdollisuuksia tehostaa muutosjohtamista tietojohtamisen keinoilla. Lisäksi työssä laadittiin muutosjohtamisen kehittämissuositukset yhdelle tutkimuksen kohteena olleelle IT-yritykselle. Tietojohtamisen kannalta muutosjohtamista tarkasteltiin erityisesti seuraavista neljästä näkökulmasta: 1) muutostarpeiden havainnointi, 2) muutoksiin suhtautuminen, 3) luottamus ja hiljainen tieto sekä 4) muutosviestintä. Empiriaosuudessa koottiin muutosjohtamisen kokemuksia kolmesta Suomessa toimivasta IT-yrityksestä. Lisänäkemystä aiheeseen haettiin kolmelta kokeneelta muutosjohtamisen asiantuntijalta. Muutosten onnistumista vaarantavat lukuisat eri tekijät. Liiketoiminnan kauan jatkunut menestys saattaa rajoittaa muutostarpeiden havaitsemista ajoissa. Luutuneet käsitykset, luottamuksen puute ja päättäjien liian vallitsevat henkilökohtaiset näkemykset estävät uusien ideoiden esiin nousemista. Muutosjohtaminen vaatii päivittäisestä johtamisesta poikkeavia erityisosaamisia. Lisäksi henkilöstön muutosvastarinta ja muutosprosessin haasteellisuus nostavat epäonnistumisen todennäköisyyttä. Tämän tutkimuksen mukaan tietojohtamisen keinoilla on mahdollisuus tehostaa muutosjohtamista. Organisaation hiljaisen tiedon saattaminen yhteiseen käyttöön edistää sekä muutostarpeiden tunnistamista että muutoshankkeiden läpivientiä. Muutosjohtamiskoulutuksella ja tiedon tehokkaalla jakamisella parannetaan henkilöstön muutosvalmiuksia ja pienennetään muutosvastarintaa. Yhtenäisellä muutosprosessilla tehostetaan muutosten läpivientiä. Muutosmyönteisen organisaatiokulttuurin luomisella on keskeinen rooli muutosvalmiuksien kehittämisessä. Muutosvision luomisella sekä laadukkaalla ja muutosviestinnällä luodaan turvallisuuden tunnetta ja varmistetaan huomion pysyminen muutoksen tavoitteiden kannalta oikeissa asioissa.

Optimization as a method of search engine marketing

This study is dedicated to search engine marketing (SEM). It aims for developing a business model of SEM firms and to provide explicit research of trustworthy practices of virtual marketing companies. Optimization is a general term that represents a variety of techniques and methods of the web pages promotion. The research addresses optimization as a business activity, and it explains its role for the online marketing. Additionally, it highlights issues of unethical techniques utilization by marketers which created relatively negative attitude to them on the Internet environment. Literature insight combines in the one place both technical and economical scientific findings in order to highlight technological and business attributes incorporated in SEM activities. Empirical data regarding search marketers was collected via e-mail questionnaires. 4 representatives of SEM companies were engaged in this study to accomplish the business model design. Additionally, the fifth respondent was a representative of the search engine portal, who provided insight on relations between search engines and marketers. Obtained information of the respondents was processed qualitatively. Movement of commercial organizations to the online market increases demand on promotional programs. SEM is the largest part of online marketing, and it is a prerogative of search engines portals. However, skilled users, or marketers, are able to implement long-term marketing programs by utilizing web page optimization techniques, key word consultancy or content optimization to increase web site visibility to search engines and, therefore, user’s attention to the customer pages. SEM firms are related to small knowledge-intensive businesses. On the basis of data analysis the business model was constructed. The SEM model includes generalized constructs, although they represent a wider amount of operational aspects. Constructing blocks of the model includes fundamental parts of SEM commercial activity: value creation, customer, infrastructure and financial segments. Also, approaches were provided on company’s differentiation and competitive advantages evaluation. It is assumed that search marketers should apply further attempts to differentiate own business out of the large number of similar service providing companies. Findings indicate that SEM companies are interested in the increasing their trustworthiness and the reputation building. Future of the search marketing is directly depending on search engines development.

Risk factors for mortality in blunt abdominal trauma with surgical approach

ABSTRACTObjective:identify risk factors for mortality in patients who underwent laparotomy after blunt abdominal trauma.Methods:retrospective study, case-control, which were reviewed medical records of blunt trauma victims patients undergoing laparotomy, from March 2013 to January 2015, and compared the result of the deaths group with the group healed.Results:of 86 patients, 63% were healed, 36% died, and one patient was excluded from the study. Both groups had similar epidemiology and trauma mechanism, predominantly young adults males, automobilistic accident. Most cases that evolved to death had hemodynamic instability as laparotomy indication - 61% against 38% in the other group (p=0.02). The presence of solid organ injury was larger in the group of deaths - 80% versus 48% (p=0.001) and 61% of them had other associated abdominal injury compared to 25% in the other group (p=0.01). Of the patients who died 96% had other serious injuries associated (p=0.0003). Patients requiring damage control surgery had a higher mortality rate (p=0.0099). Only one of 18 patients with isolated hollow organ lesion evolved to death (p=0.0001). The mean injury score of TRISS of cured (91.70%) was significantly higher than that of deaths (46.3%) (p=0.002).Conclusion:the risk factors for mortality were hemodynamic instability as an indication for laparotomy, presence of solid organ injury, multiple intra-abdominal injuries, need for damage control surgery, serious injury association and low index of trauma score.

Yhdessä tuumin kohti turvallisempaa liikkumista : Loimaan seudun liikenneturvallisuussuunnitelma

Loimaan seudun liikenneturvallisuussuunnitelma on laadittu seudun kuntien ja Varsinais-Suomen ELY-keskuksen yhteistyönä. Liikenneturvallisuussuunnitelman tavoitteena on edistää kokonaisvaltaisella tavalla nykyistä vastuullisempaa ja turvallisuushakuisempaa liikkumista seudulla. Suunnitelmassa esitetyillä toimenpiteillä pyritään merkittävästi vähentämään seudulla tapahtuvien liikennekuolemien ja liikenteessä loukkaantuneiden määrää. Tavoitteena on myös edistää nykyistä kestävämpää liikkumista, jolla terveys- ja ympäristövaikutusten ohella on myönteinen vaikutus myös liikenneturvallisuuskehitykseen. Loimaan seudulla tapahtuu vuosittain keskimäärin viisi kuolemaan ja 70 loukkaantumiseen johtanutta onnettomuutta. Asukaslukuun suhteutettuna Loimaan seudulla tapahtuu selvästi enemmän henkilövahinko-onnettomuuksia kuin maakunnassa tai koko maassa keskimäärin. Myös liikenneonnettomuuksien vakavuusaste on maakunnan ja koko maan keskitasoa korkeampi. Kulkutavoittain tarkasteltuna korostuvat erityisesti henkilöauto-onnettomuudet. Liikennekuolemista peräti kolme neljäsosaa on tapahtunut autoilijoille. Ikäryhmittäin tarkasteltuna suurin onnettomuusriski on 15–24-vuotiailla, jotka muodostavat seudun liikenteen uhreista 39 prosenttia (ikäryhmän osuus seudun väestöstä on 11 prosenttia). Liikenneonnettomuuksista aiheutuu seudun kunnille vuosittain lähes kahdeksan miljoonan euron kustannukset – yli 200 euroa asukasta kohden. Nykytilan kuvausten pohjalta ja valtakunnalliset linjaukset huomioiden seudun liikenneturvallisuustyölle on asetettu pitkän aikavälin visio, määrälliset liikenneonnettomuuksien vähentämistavoitteet sekä lähivuosien toimintaa suuntaavat kärkitehtävät. Tavoitteiden mukaan seudun liikennekuolemien määrän tulee vähentyä nykyisestä viidestä hengestä1-2 henkeen vuoteen 2020 mennessä. Loukkaantumisten määrän tulee vähentyä nykyisestä 95 henkilöstä vähintään 71 henkilöön vuoteen 2020 mennessä (-25 %). Suunnitelmassa asetettujen tavoitteiden saavuttamiseen pyritään monipuolisen ja toimien vaikuttavuuden perusteella kohdennetun toimenpidejoukon keinoin sekä kehittämällä eri toimijoiden välistä yhteistyötä ja työnjakoa toimenpiteiden edistämisessä. Suunnitelmassa on esitetty 14 kärkitehtäväkokonaisuutta, joihin toiminta tulee vaikuttavuuden perusteella ensisijaisesti kohdistaa. Suunnitelman vaikutustenarvioinnin perusteella voidaan todeta, että keinot asetettujen tavoitteiden saavuttamiseksi ovat olemassa, mutta tavoitteisiin pääseminen edellyttää erittäin suuria panostuksia kaikilla liikenneturvallisuustyön osa-alueilla, ja erityisesti liikennekäyttäytymiseen ja yhteistyöhön kohdistuvien toimenpiteiden osalta. Liikennekuolemien puolittamisen tavoite nykytasosta vuoteen 2020 on tehtyjen tarkastelujen perusteella mahdollista. Myös loukkaantumisten määrän vähentäminen on saavutettavissa esitetyin toimenpitein.

Detection and characterization of fibropapilloma associated herpesvirus of marine turtles in Rio Grande do Sul, Brazil

Fibropapillomatosis (FP) is a benign tumoral disease that affects sea turtles, hampering movement, sight and feeding, ultimately leading to death. In Brazil, the disease was described for the first time in 1986. Research suggests the involvement of a herpesvirus in association with environmental and genetic factors as causal agents of FP. The objective of the present study was to detect and characterize this herpesvirus in sea turtles living in the coast of state Rio Grande do Sul (RS), Brazil. From October 2008 to July 2010, 14 turtles were observed between the beaches of Torres and Tavares, of which 11 were green turtles (Chelonia mydas) and 3 were loggerhead turtles (Caretta caretta). All turtles were young and mean curved carapace length was 37.71±7.82cm, and varied from 31 to 55cm. Only one green turtle presented a 1cm, papillary, pigmented fibropapilloma. Skin and fibropapilloma samples were analyzed by conventional and real time PCR assays to detect and quantify herpesvirus. All skin samples were negative, though the fibropapilloma specimen was positive in both tests. Viral load was 9,917.04 copies of viral genome per milligram of tissue. The DNA fragment amplified from the fibropapilloma sample was sequenced and allocated in the Atlantic phylogeographic group. This study reports the first molecular characterization of herpesvirus associated with fibropapilloma in turtles from the coast of RS.

Systemic acanthamoebiasis associated with canine distemper in dogs in the semiarid region of Paraíba, Brazil

Infections by free-living amoebae can cause systemic disease in animals and humans. We describe the epidemiological, clinical and pathological aspects of disseminated acanthamoebiasis associated with canine distemper in three dogs of the semiarid region of Paraíba, Northeastern Brazil. Affected dogs developed progressive neurological and respiratory signs that progressed to death within in two to 20 days. Gross lesions were irregular and with yellow-reddish nodules randomly distributed in the lungs, heart, kidneys, spleen, lymph nodes, adrenals, and intestine. One dog had foci of malacia in the parietal cortex and another one in nucleus of brain basis. Histologically, pyogranulomas with areas of necrosis and hemorrhage in all organs affected were observed, associated with myriads of intralesional amoebic trophozoites. All three cases were concomitant canine distemper, that possibly triggered immunosuppression in the dogs. The diagnosis was performed through microscopic findings of infection by free-living amoebae and confirmed Acanthamoeba sp. by immunohistochemistry

Outbreaks of canid herpesvirus 1 disease in puppies in southern Brazil

Abstract: Canid herpesvirus 1 (CHV-1) is a widespread pathogen of dogs and produces infertility, abortions and severe systemic disease in young puppies. Clinical data indicate the circulation of CHV-1 among Brazilian dogs yet definitive diagnosis has rarely been accomplished. This article describes the clinicopathological findings of four independent cases/outbreaks of neonatal disease by CHV-1 in Bulldog puppies followed by virus identification and genetic characterization. Three events occurred in a kennel holding dogs of different breeds at reproductive age (March 2013, October 2013 and April 2014). Puppies from three French or English Bulldog litters, aging 9 to 30 days were affected, presenting dyspnea, agonic breathing, pale mucous, abdominal pain and tension, evolving to death within about 24 hours. At necropsy, the puppies presented necrohemorrhagic hepatitis, multifocal and moderate necrohemorrhagic nephritis and fibrinonecrotic interstitial pneumonia. Virus isolation was positive in clinical specimens from one litter and CHV-1 DNA was detected by PCR in tissues from all four cases. Virus-neutralizing assays with samples of the affected kennel revealed 9/12 adult animals with high antibody titers to CHV-1. Nucleotide sequencing of glycoprotein B, C and D genes revealed 99-100% of identity among the viruses and with CHV-1 sequences available in GenBank. Phylogenetic analyses of gC sequences showed a segregation of the samples, even among three isolates from the same kennel. These findings support CHV-1 infection as the cause of disease and death in these dog litters, reinforcing the need for correct etiologic diagnosis, prevention and immunization against CHV-1 in dogs from Southern Brazil.

Why did the perfect marriage end : case Cloetta Fazer

Mergers are often used purposeful strategic tool. Previous research has mainly concentrated on actu-al M&A process and to elements leading to that decision. Purpose of this study is to approach de-merger of Cloetta Fazer and research what were the reasons that lead to demerger. Problem is ap-proached by first evaluating was the merger an success in the first place, as described in earlier stud-ies, media and academic research. From this information the motives for demerger are approached. Research material for study is collected from second hand sources. Research data-sample was di-vided into two categories: Timeline Sample & Additional Information Sample. Timeline sample was collected by systematically collecting news from Sanoma News database and Alma News database. This data was indexed and a timeline was constructed. From this timeline key dates, themes and elements were identified and further data gathering was concentrated based on those themes. Results of the study suggest that Merger was not as great success as it was described in earlier years. Explanations why merger ended up into demerger vary greatly. From material key factor, lack of, or error in, long term strategic planning was identified. This was due to death in family during strategy creation and mistakes made in pre-merger phase.

Intracranial Nimodipine Implant: Feasibility and Implications for the Treatment of Subarachnoid Hemorrhage – A Pre-Clinical Study

Intracranial aneurysmal subarachnoid hemorrhage (aSAH) is a life-threatening condition requiring immediate neurocritical care. A ruptured aneurysm must be isolated from arterial circulation to prevent rebleeding. Open surgical clipping of the neck of the aneurysm or intra-arterial filling of the aneurysm sack with platinum coils are major treatment strategies in an acute phase. About 40% of the patients suffering from aSAH die within a year of the bleeding despite the intensive treatment. After aSAH, the patient may develop a serious complication called vasospasm. Major risk for the vasospasm takes place at days 5–14 after the primary bleeding. In vasospasm, cerebral arteries contract uncontrollably causing brain ischemia that may lead to death. Nimodipine (NDP) is used to treat of vasospasm and it is administrated intravenously or orally every four hours for 21 days. NDP treatment has been scientifically proven to improve patients’ clinical outcome. The therapeutic effect of L-type calcium channel blocker NDP is due to the ability to dilate cerebral arteries. In addition to vasodilatation, recent research has shown the pleiotropic effect of NDP such as inhibition of neuronal apoptosis and inhibition of microthrombi formation. Indeed, NDP inhibits cortical spreading ischemia. Knowledge of the pathophysiology of the vasospasm has evolved in recent years to a complex entity of early brain injury, secondary injuries and cortical spreading ischemia, instead of being pure intracranial vessel spasm. High NDP levels are beneficial since they protect neurons and inhibit the cortical spreading ischemia. One of the drawbacks of the intravenous or oral administration of NPD is systemic hypotension, which is harmful particularly when the brain is injured. Maximizing the beneficial effects and avoiding systemic hypotension of NDP, we developed a sustained release biodegradable NDP implant that was surgically positioned in the basal cistern of animal models (dog and pig). Higher concentrations were achieved locally and lower concentrations systemically. Using this treatment approach in humans, it may be possible to reduce incidence of harmful hypotension and potentiate beneficial effects of NDP on neurons. Intracellular calcium regulation has a pivotal role in brain plasticity. NDP blocks L-type calcium channels in neurons, substantially decreasing intracellular calcium levels. Thus, we were interested in how NDP affects brain plasticity and tested the hypothesis in a mouse model. We found that NDP activates Brain-derived neurotrophic factor (BDNF) receptor TrkB and its downstream signaling in a reminiscent of antidepressant drugs. In contrast to antidepressant drugs, NDP activates Akt, a major survival-promoting factor. Our group’s previous findings demonstrate that long-term antidepressant treatment reactivates developmental-type of plasticity mechanisms in the adult brain, which allows the remodeling of neuronal networks if combined with appropriate rehabilitation. It seems that NDP has antidepressant-like properties and it is able to induce neuronal plasticity. In general, drug induced neuronal plasticity has a huge potential in neurorehabilitation and more studies are warranted.

Immunohistochemical detection of virus through its nuclear cytopathic effect in idiopathic interstitial pneumonia other than acute exacerbation

Idiopathic interstitial pneumonias include complex diseases that have a strong interaction between genetic makeup and environmental factors. However, in many cases, no infectious agent can be demonstrated, and these clinical diseases rapidly progress to death. Theoretically, idiopathic interstitial pneumonias could be caused by the Epstein-Barr virus, cytomegalovirus, adenovirus, hepatitis C virus, respiratory syncytial virus, and herpesvirus, which may be present in such small amounts or such configuration that routine histopathological analysis or viral culture techniques cannot detect them. To test the hypothesis that immunohistochemistry provides more accurate results than the mere histological demonstration of viral inclusions, this method was applied to 37 open lung biopsies obtained from patients with idiopathic interstitial pneumonias. As a result, immunohistochemistry detected measles virus and cytomegalovirus in diffuse alveolar damage-related histological patterns of acute exacerbation of idiopathic pulmonary fibrosis and nonspecific interstitial pneumonia in 38 and 10% of the cases, respectively. Alveolar epithelium infection by cytomegalovirus was observed in 25% of organizing pneumonia patterns. These findings were coincident with nuclear cytopathic effects but without demonstration of cytomegalovirus inclusions. These data indicate that diffuse alveolar damage-related cytomegalovirus or measles virus infections enhance lung injury, and a direct involvement of these viruses in diffuse alveolar damage-related histological patterns is likely. Immunohistochemistry was more sensitive than the histological demonstration of cytomegalovirus or measles virus inclusions. We concluded that all patients with diffuse alveolar damage-related histological patterns should be investigated for cytomegalovirus and measles virus using sensitive immunohistochemistry in conjunction with routine procedures.

Measuring Effectiveness of Marketing Message: The Role of Verbal, Visual and Brand Elements

The aim of this paper is to study the role of verbal, visual and brand elements while meas-uring effectiveness of marketing message. The thesis is written in the context of mobile gaming industry. The object of the study is marketing message. To achieve the aim, the main research question was formulated: How do the elements of marketing message, such as verbal, visual and brand, affect the consumer’s attitude toward the ad, emotional response and attention capture? The theory development chapter lays on three corner stones – analysis of previous litera-ture on marketing message and its elements, namely verbal, visual and brand; overview of literature on attitude formation and particularly attitude toward the ad. In addition, investiga-tion of key points of emotional response and attention capture literature finalizes the chap-ter. The empirical part consists of experiment, conducted with 27 participants. Experiment includes the self-report semantically anchored scale, measuring the attitude toward the ad, as well as autonomic measures – eye tracking (attention capture) and facial expressions (emotional response). The results of the experiment showed that the size of the brand element – the logo – has an effect on the attention capture and the overall attitude toward the ad. The bigger the logo, the more time people spend viewing it, and they realise the message is more educa-tional and factual. The measure related to the visual element – the visual complexity – in-creases the intensity of participant’s facial expression. While the measure of verbal ele-ment – the contrast between text and background colours – leads to a better attitude to-ward the ad. The higher the contrast between text and background, the more known the message appears to the viewer.

Flipped classroom technology from teachers’ perspective: implementation experience, barriers and perspectives

Blended learning approaches rise their popularity, however not all professors apply them and find them useful and appropriate. This research focuses on study of flipped classroom arrangement and effectiveness of this concept implementation. The Master’s Thesis explores impact of flipped classroom implementation on resource savings for proffesors. The research is based on the literature review of different education arrangements and results of their implementation, on the survey conducted among proffesors from different Universities and on two experiments of flipped classroom implementation. The results reveal advantages and disadvantages of the concept, professors’ attitude to it and possibility to future research and practice in this field