Does change talk during brief motivational interventions with young men predict change in alcohol use?

Client change talk (CT) during motivational interviewing and brief motivational interventions (BMIs) have been described as predictors of behavior change, but these links have not been clearly evaluated in research on young people. Within 127 BMIs with 20-year-old men with at-risk alcohol consumption, each CT utterance was categorized and given a strength rating using the Motivational Interviewing Skill Code 2.1. Several ways of categorizing and measuring CT were tested using stepwise regression procedures. Overall CT measures were not significantly related to changes in drinking at 6-month follow-up. Regarding CT sub-dimensions, the frequency of ability/desire/need to change and of ability/desire/need not to change, as well as the average strength of ability/desire/need, predicted significant change in the expected direction. CT length was not significantly linked to outcome. The frequency and strength with which some CT sub-dimensions are expressed during BMI seemed to be important predictors of change in drinking among young men and might thus be especially important for clinicians to notice.

Welfare regimes and change in the employment structure: Britain, Denmark and Germany since 1990

Welfare states are often reduced to their role as providers of social protection and redistribution. In 1990, Esping-Andersen argued that they also affect employment creation and the class structure. We analyse the stratification outcomes for three welfare regimes - Britain, Germany and Denmark - over the 1990s and 2000s. Based on individual-level surveys, we observe a disproportionate increase among professionals and managers, and a decline among production workers and clerks. The result is clear-cut occupational upgrading in Denmark and Germany. In Britain, high and low-end service jobs expanded, resulting in a polarized version of upgrading. Growth in low-end service jobs - and thus polarization - is no precondition for full employment. Both Britain and Denmark halved their low-educated unemployment rate between 1995 and 2008. Yet low-end service jobs expanded only in Britain, not in Denmark. The cause is the evolution of labour supply: rising educational attainment means that fewer low-educated workers look for low-skilled jobs.

Ultrasound evaluation of synovitis in RA: Correlation with clinical disease activity and sensitivity to change in an observational cohort study.

OBJECTIVE: To evaluate the correlation between clinical measures of disease activity and a ultrasound (US) scoring system for synovitis applied by many different ultrasonographers in a daily routine care setting within the Swiss registry for RA (SCQM) and further to determine the sensitivity to change of this US Score. METHODS: One hundred and eight Swiss rheumatologists were trained in performing the Swiss Sonography in Arthritis and Rheumatism (SONAR) score. US B-mode and Power Doppler (PwD) scores were correlated with DAS28 and compared between the clinical categories in a cross-sectional cohort of patients. In patients with a second US (longitudinal cohort), we investigated if change in US score correlated with change in DAS and evaluated the responsiveness of both methods. RESULTS: In the cross-sectional cohort with 536 patients, correlation between the B-mode score and DAS28 was significant but modest (Pearson coefficient r=0.41, P<0.0001). The same was true for the PwD score (r=0.41, P<0.0001). In the longitudinal cohort with 183 patients we also found a significant correlation between change in B-mode and in PwD score with change in DAS28 (r=0.54, P<0.0001 and r=0.46, P<0.0001, respectively). Both methods of evaluation (DAS and US) showed similar responsiveness according to standardized response mean (SRM). CONCLUSIONS: The SONAR Score is practicable and was applied by many rheumatologists in daily routine care after initial training. It demonstrates significant correlations with the degree of as well as change in disease activity as measured by DAS. On the level of the individual, the US score shows many discrepancies and overlapping results exist.

Effect of once-yearly zoledronic acid five milligrams on fracture risk and change in femoral neck bone mineral density.

CONTEXT: In the Health Outcomes and Reduced Incidence with Zoledronic Acid Once Yearly - Pivotal Fracture Trial (HORIZON-PFT), zoledronic acid (ZOL) 5 mg significantly reduced fracture risk. OBJECTIVE: The aim of the study was to identify factors associated with greater efficacy during ZOL 5 mg treatment. DESIGN, SETTING, AND PATIENTS: We conducted a subgroup analysis (preplanned and post hoc) of a multicenter, double-blind, placebo-controlled, 36-month trial in 7765 women with postmenopausal osteoporosis. Intervention: A single infusion of ZOL 5 mg or placebo was administered at baseline, 12, and 24 months. MAIN OUTCOME MEASURES: Primary endpoints were new vertebral fracture and hip fracture. Secondary endpoints were nonvertebral fracture and change in femoral neck bone mineral density (BMD). Baseline risk factor subgroups were age, BMD T-score and vertebral fracture status, total hip BMD, race, weight, geographical region, smoking, height loss, history of falls, physical activity, prior bisphosphonates, creatinine clearance, body mass index, and concomitant osteoporosis medications. RESULTS: Greater ZOL induced effects on vertebral fracture risk were seen with younger age (treatment-by-subgroup interaction, P = 0.05), normal creatinine clearance (P = 0.04), and body mass index >or= 25 kg/m(2) (P = 0.02). There were no significant treatment-factor interactions for hip or nonvertebral fracture or for change in BMD. CONCLUSIONS: ZOL appeared more effective in preventing vertebral fracture in younger women, overweight/obese women, and women with normal renal function. ZOL had similar effects irrespective of fracture risk factors or femoral neck BMD.

Myriophyllum aquaticum (Vell.) Verdc. (Haloragaceae), una espècie invasora en procés de naturalització als Països Catalans = Myriophyllum aquaticum (Vell.) Verdc. (Haloragaceae), an invasive species in the process of naturalisation in the Catalan Countries

Nota breu sobre la descripció de Myriophyllum aquaticum (Vell.) Verdc. (Haloragaceae) als Països Catalans

Utilization of Knowledge Management in Business Process Modeling and Process Improvements

Tutkimuksen tavoitteena on tutkia telekommunikaatioalalla toimivan kohdeyrityksen ohjelmistojen toimitusprosessia° Tutkimus keskittyy mallintamaan toimitusprosessin, määrittelemään roolit ja vastuualueet, havaitsemaan ongelmakohdat ja ehdottamaan prosessille kehityskohteita. Näitä tavoitteita tarkastellaan teoreettisten prosessimallinnustekniikoiden ja tietojohtamisen SECI-prosessikehyksen läpi. Tärkein tiedonkeruun lähde oli haastatteluihin perustuva tutkimus, johon osallistuvat kaikki kohdeprosessiin kuuluvat yksiköt. Mallinnettu toimitusprosessi antoi kohdeyritykselle paremman käsityksen tarkasteltavasta prosessista ja siinä toimivien yksiköiden rooleistaja vastuualueista. Parannusehdotuksia olivat tiedonjaon kanavoinnin määritteleminen, luottamuksen ja sosiaalisten verkostojen parantaminen, ja tietojohtamisen laajamittainen implementointi.

Task Support in Scenario Process: Case LUT 2016

This thesis attempts to find whether scenario planning supports the organizational strategy as a method for addressing uncertainty. The main issues are why, what and how scenario planning fits in organizational strategy and how the process could be supported to make it more effective. The study follows the constructive approach. It starts with examination of competitive advantage and the way that an organization develops strategy and how it addresses the uncertainty in its operational environment. Based on the conducted literature review, scenario methods would seem to provide versatile platform for addressing future uncertainties. The construction is formed by examining the scenario methods and presenting suitable support methods, which results in forming of the theoretical proposition for supporter scenario process. The theoretical framework is tested in laboratory conditions, and the results from the test sessions are used a basis for scenario stories. The process of forming the scenarios and the results are illustrated and presented for scrutiny

KLF2 mutation is the most frequent somatic change in splenic marginal zone lymphoma and identifies a subset with distinct genotype.

To characterise the genetics of splenic marginal zone lymphoma (SMZL), we performed whole exome sequencing of 16 cases and identified novel recurrent inactivating mutations in Kruppel-like factor 2 (KLF2), a gene whose deficiency was previously shown to cause splenic marginal zone hyperplasia in mice. KLF2 mutation was found in 40 (42%) of 96 SMZLs, but rarely in other B-cell lymphomas. The majority of KLF2 mutations were frameshift indels or nonsense changes, with missense mutations clustered in the C-terminal zinc finger domains. Functional assays showed that these mutations inactivated the ability of KLF2 to suppress NF-κB activation by TLR, BCR, BAFFR and TNFR signalling. Further extensive investigations revealed common and distinct genetic changes between SMZL with and without KLF2 mutation. IGHV1-2 rearrangement and 7q deletion were primarily seen in SMZL with KLF2 mutation, while MYD88 and TP53 mutations were nearly exclusively found in those without KLF2 mutation. NOTCH2, TRAF3, TNFAIP3 and CARD11 mutations were observed in SMZL both with and without KLF2 mutation. Taken together, KLF2 mutation is the most common genetic change in SMZL and identifies a subset with a distinct genotype characterised by multi-genetic changes. These different genetic changes may deregulate various signalling pathways and generate cooperative oncogenic properties, thereby contributing to lymphomagenesis.

Biochemical treatment of brown grade rejects in recycling process

Ruskeisiin kierrätysmassoihin kuuluu kulutuksen kannalta tärkeimpänä laatuna OCC (old corrugated containers). OCC sisältää noin 70-100% aaltopahvia eli pääasiassa se koostuu valkaisemattomasta kemiallisesta massasta. OCC uusiomassan ensisijainen käyttökohde on aaltopahvin valmistus. OCC:n kierrätyskuituprosessissa syntyy merkittäviä määriä rejektiä. Rejektin määrä riippuu paljolti kierrätettävän materiaalin laadusta ja puhtaudesta, mutta myös tulevan massan käyttötarkoituksesta sekä prosessiolosuhteista. OCC-prosessissa rejektoituvan aineksen määrä voi nousta korkeaksi, mikäli kierrätettävä materiaali sisältää märkälujaliimoja tai muuten raskaasti liimattuja komponentteja sekä runsaasti kontaminantteja, kuten muoveja, teippejä ja metalleja. Keskimäärin OCC-rejekti sisältää 30-60% kiinteää ainesta, 30-90% (kuivapaino) kuituja, 5-70% (kuivapaino) muoveja ja 1-10% (kuivapaino) tuhkaa. Syntynyt rejekti voidaan polttaa energiaksi tai käyttää maantäyttöaineena. Harvinaisempia sovelluksia rejektin käsittelyssä ovat rejektin kuitujen talteenotto uudelleenprosessointia varten tai alkoholin ja levuliinihapon tuottamiseen. Rejektin asianmukaisella käsittelyllä voidaan vähentää kaatopaikkakustannuksia, sekä parantaa kierrätysprosessin tuottavuutta. Tämän työn tarkoituksena oli tutkia biokemiallisen käsittelyn mahdollisuudet OCC-rejektin hajotuksessa. Alustavissa laboratoriomittakaavan kokeissa etsittiin sopiva käsittelytapa, joka toteutettiin sitten pilot plant -mittakaavassa. Tulokset osoittavat, että biokemiallisen käsittelyn avulla rejekti voidaan hajottaa jolloin jätteenkäsittelykustannukset pienenevät ja kierrätyskuituprosessin taloudellisuus paranee.

Trace element monitoring in the ICU: quality and economic impact of a change in sampling practice.

BACKGROUND & AIMS: Trace elements (TE) are involved in the immune and antioxidant defences which are of particular importance during critical illness. Determining plasma TE levels is costly. The present quality control study aimed at assessing the economic impact of a computer reminded blood sampling versus a risk guided on-demand monitoring of plasma concentrations of selenium, copper, and zinc. METHODS: Retrospective analysis of 2 cohorts of patients admitted during 6 months periods in 2006 and 2009 to the ICU of a University hospital. INCLUSION CRITERIA: to receive intravenous micronutrient supplements and/or to have a TE sampling during ICU stay. The TE samplings were triggered by computerized reminder in 2006 versus guided by nutritionists in 2009. RESULTS: During the 2 periods 636 patients met the inclusion criteria out of 2406 consecutive admissions, representing 29.7% and 24.9% respectively of the periods' admissions. The 2009 patients had higher SAPS2 scores (p = 0.02) and lower BMI compared to 2006 (p = 0.007). The number of laboratory determinations was drastically reduced in 2009, particularly during the first week, despite the higher severity of the cohort, resulting in à 55% cost reduction. CONCLUSIONS: The monitoring of TE concentrations guided by a nutritionist resulted in a reduction of the sampling frequency, and targeting on the sickest high risk patients, requiring a nutritional prescription adaptation. This control leads to cost reduction compared to an automated sampling prescription.