Riskitiedon tehokkaampi hyödyntäminen kansainvälisessä projektiliiketoiminnassa

Tutkimuksessa selvitettiin riskitiedon siirtoon ja hyödyntämiseen käytettyjä työkaluja ja toimintatapoja projektin myynti- ja toteutusvaiheessa. Toisena tavoitteena oli tuoda esille projektiympäristössä riskitiedon tehokkaaseen siirtämiseen ja hyödyntämiseen vaikuttavat seikat. Työssä peilataan kirjallisuudessa esitettyjä riskienhallinnan käytäntöjä yrityksen riskienhallinnan toimintatapoihin ja etsitään sopivia tapoja muokata nykyisiä riskitiedon hyödyntämistapoja tehokkaammaksi. Tutkimus toteutettiin tapaustutkimuksena ja aineistoa kerättiin syventävän haastattelun avulla, päivittämällä riskien tarkastuslista, tutkimalla järjestelmistä saatavia dokumentteja sekä GPSII -kehitysyhteistyöhankkeen tuloksia. Tutkimuksen tuloksena löydettiin riskitiedon hyödyntämiseen liittyviä ongelmia. Lisäksi todettiin selkeä tarve kehittää muutoksenhallintaan liittyvää tietokantajärjestelmää että tarve lisätä riskien tarkastuslistan läpikäyntikertojen määrää ja säännöllisyyttä.

The REporting of studies Conducted using Observational Routinely-collected health Data (RECORD) statement.

Routinely collected health data, obtained for administrative and clinical purposes without specific a priori research goals, are increasingly used for research. The rapid evolution and availability of these data have revealed issues not addressed by existing reporting guidelines, such as Strengthening the Reporting of Observational Studies in Epidemiology (STROBE). The REporting of studies Conducted using Observational Routinely collected health Data (RECORD) statement was created to fill these gaps. RECORD was created as an extension to the STROBE statement to address reporting items specific to observational studies using routinely collected health data. RECORD consists of a checklist of 13 items related to the title, abstract, introduction, methods, results, and discussion section of articles, and other information required for inclusion in such research reports. This document contains the checklist and explanatory and elaboration information to enhance the use of the checklist. Examples of good reporting for each RECORD checklist item are also included herein. This document, as well as the accompanying website and message board (http://www.record-statement.org), will enhance the implementation and understanding of RECORD. Through implementation of RECORD, authors, journals editors, and peer reviewers can encourage transparency of research reporting.

Subtypes of adolescents with substance use disorders and psychiatric comorbidity using cluster and discriminant analysis of MMPI-A profiles

The main aim of this study was to replicate and extend previous results on subtypes of adolescents with substance use disorders (SUD), according to their Minnesota Multiphasic Personality Inventory for adolescents (MMPI-A) profiles. Sixty patients with SUD and psychiatric comorbidity (41.7% male, mean age = 15.9 years old) completed the MMPI-A, the Teen Addiction Severity Index (T-ASI), the Child Behaviour Checklist (CBCL), and were interviewed in order to determine DSMIV diagnoses and level of substance use. Mean MMPI-A personality profile showed moderate peaks in Psychopathic Deviate, Depression and Hysteria scales. Hierarchical cluster analysis revealed four profiles (acting-out, 35% of the sample; disorganized-conflictive, 15%; normative-impulsive, 15%; and deceptive-concealed, 35%). External correlates were found between cluster 1, CBCL externalizing symptoms at a clinical level and conduct disorders, and between cluster 2 and mixed CBCL internalized/externalized symptoms at a clinical level. Discriminant analysis showed that Depression, Psychopathic Deviate and Psychasthenia MMPI-A scales correctly classified 90% of the patients into the clusters obtained.

Sentiment d'impuissance et coping de l'aidant familial lors de l'hospitalisation du proche en milieu de soins aigus : étude descriptive corrélationnelle

Problématique. Le vieillissement de la population continuera à transformer la démographie. Sa conséquence est une augmentation des besoins de santé chez les personnes âgées que le système sanitaire ne peut couvrir à lui seul. La contribution conséquente des aidants familiaux constitue un pilier nécessaire et essentiel du maintien à domicile. Or, les exigences du rôle d'aidant peuvent dépasser ses capacités et conduire à une hospitalisation. Ces sources de stress, auxquelles s'ajoutent les manifestations de la maladie du proche et des difficultés de collaboration avec les professionnels de santé, peuvent générer un sentiment d'impuissance chez l'aidant. Ce dernier s'ajuste à ce stress par des stratégies de coping, influencées par le degré de contrôle perçu, dont le niveau le plus bas est l'impuissance. But. Explorer la relation entre le sentiment d'impuissance et le coping chez l'aidant à l'occasion de l'hospitalisation du proche. Méthode. Cette étude corrélationnelle descriptive a été conduite auprès de 33 aidants familiaux dont le proche est hospitalisé, recrutés selon un échantillonnage de convenance. Le questionnaire auto-administré comportait trois1 instruments : (a) questionnaire sociodémographique, (b) Ways of Coping Checklist-R, (c) sous-échelle d'impuissance de l'Empowerment Scale (allant de 1 à 4, quatre correspondant à un faible degré d'impuissance). Des comparaisons de moyennes et des corrélations de Pearson ont été effectués. Résultats. L'échantillon est constitué de 45,45 % d'hommes aidants, âgés en moyenne de 61 ans. Les participants viennent en aide à des proches âgés en moyenne de 79 ans. Pour la plus grande part, les aidants assistent leurs proches pour les activités instrumentales de la vie quotidienne. La moitié de l'échantillon fournit de 1 à 5 heures d'aide par semaine. Les participants se sentent relativement peu impuissants (M = 2,55). Cependant, plus l'âge des aidants augmente, plus l'impuissance augmente (r = -0,45 ; p < 0,0106). L'impuissance est plus élevée chez les hommes que chez les femmes (M = 2,40 vs M = 2,67 ; p = 0,0270). Dans cet échantillon, il n'y a pas de différence de sentiment d'impuissance selon que les aidants fournissent ou non une aide pour les activités de la vie quotidienne (AVQ), ni selon le nombre d'heures d'aide fournies par semaine. Le style de coping privilégié par les aidants est le coping centré sur le problème, puis sur la recherche de soutien social et finalement sur l'émotion. Les aidants fournissant de l'aide dans les AVQ privilégient le coping centré sur l'émotion alors qu'il n'existe pas de différence pour les deux autres styles de coping. Aucune relation entre l'impuissance et le coping n'apparaît. Conclusions. Malgré les limites de l'étude, notamment liées à la mesure de l'impuissance, les présents résultats sont compatibles avec les études antérieures. Il est néanmoins préconisé d'approfondir les connaissances utiles au renforcement du rôle infirmier auprès des aidants familiaux. Cela doit contribuer à préserver la santé de l'aidant, son rôle auprès du proche et le maintien à domicile de ce dernier.

Stress, coping and personal strengths and difficulties in internationally adopted children in spain

This study analyses the types of coping strategies used by internationally adopted children, and explores the relation between these strategies and personal strengths and difficulties. The Kidcope checklist (Spirito, Stark, & Williams, 1998) and the Strengths and Difficulties Questionnaire (SDQ; Goodman, 1997) were administered to a sample of 35 Spanish adoptees (25.7% boys and 74.3% girls, aged 8-12 years) and their parents. Self-reported problems were categorised and their relation with coping strategies and psychological adjustment was explored. Results indicated that adopted children report problems of interpersonal nature. The content of the problems mainly refers to relationships and health, illness, or accidents. Parents reported that children were generally well-adjusted and they had no problems outside the normal range. International adoptees used mainly control-oriented coping strategies. Escape-oriented coping was linked to parents' ratings of total difficulties, with self-criticism accounting for the highest percentage of the variance.

Statistics in Public Understanding of Science review: How to achieve high statistical standards?

This article proposes a checklist to improve statistical reporting in the manuscripts submitted to Public Understanding of Science. Generally, these guidelines will allow the reviewers (and readers) to judge whether the evidence provided in the manuscript is relevant. The article ends with other suggestions for a better statistical quality of the journal.

Eficacia de las intervenciones de prevención de caídas en pacientes geriátricos institucionalizados. Revisión sistemática y metaanálisis

Objetivo: Determinar la eficacia de las intervenciones de prevención de caídas en personas mayores institucionalizadas. Material y métodos: La población de estudio consistió en ensayos clínicos controlados y aleatorizados acerca de intervenciones de prevención primaria de caídas, en ancianos institucionalizados en residencias y unidades de larga estancia, publicados en los últimos 15 años en el ámbito mundial. Se realizó un análisis de metaanálisis para determinar la eficacia de las intervenciones de prevención de caídas. Resultados: El equipo investigador revisó un total de 2.382 estudios, de los cuales se seleccionaron 156; finalmente se analizan 7 estudios de forma enmascarada, previo examen de su calidad metodológica mediante Checklist of Consort Statement (2002). Las intervenciones de prevención de caídas en pacientes geriátricos, institucionalizados en residencias geriátricas y unidades de larga estancia reducen de forma global la posibilidad de caerse (odds ratio = 0,63; intervalo de confianza del 95%, 0,53-0,74). Conclusiones: Las intervenciones de prevención de caídas en residencias geriátricas y unidades de larga estancia consiguen disminuir en 1,58 veces la posibilidad de caerse. Se destaca la formación del equipo como uno de los aspectos clave en la prevención, acompañada por un enfoque del problema multifactorial, interdisciplinar e individualizado.

Step-by-step of ultrasound-guided core-needle biopsy of the breast: review and technique

Ultrasound-guided core-needle biopsy has high sensitivity in the diagnosis of breast cancer. The present study is aimed at detailing the main steps of such procedure, including indications, advantages, limitations, follow-up and description of the technique, besides presenting a checklist including the critical steps required for an appropriate practice of the technique. In the recent years, an increasing number of patients have required breast biopsy, indicating the necessity of a proportional increase in the number of skilled professionals to carry out the procedures and histological diagnoses. A multidisciplinary approach involving the tripod clinical practice-radiology-pathology is responsible for the highest rate of accuracy of the technique and must always be adopted.

Combining Customer Requirements and Modularity in Complete Tap Water Solution

This thesis studies forming a complete solution concept for tap water systems in project business environment. The aim of the study is to find tools and means for the target company to determine the scope of their tap water solution offering and to research what kind of organizational capabilities and resources are needed to supply such system solutions. With the help of literature, the characteristics of systems selling and project business and thematics of systems integration and integrated solutions are examined, and the significance of modularity and customer requirements in the given operational environment is discussed. After this, a checklist tool for customer requirements management is developed for the tap water system along with a module allocation method. The study proposes that with the checklist and module allocation the technical specifications can be extensively and innovatively defined for the system. The tools developed are a part of a complete tap water solution concept, which suggests that integrated solutions might constitute possibilities for the company to outperform its competitors when the traditional business methods of the industry are becoming obsolete.

Characterization of clinical and electrocardiographic findings in a youth population

Resting 12-lead electrocardiogram (ECG) has been employed in the evaluation of young asymptomatic subjects to detect pre-existing heart diseases. Although the incorporation of routine ECG remains controversial, there is increasing evidence that cardiomyopathies and ion channelopathies show ECG changes as the initial manifestation. The causes of sudden cardiac death in young people show a significant geographical variation. We aim to determine the prevalence and spectrum of ECG findings in a youth population. Methodology: From May 2010 to April 2013, a total of 976 young secondary school students (mean age, 14 years; range, 13-15) underwent voluntary medical screening that included a resting 12-lead ECG and structured clinical survey. Subjects with abnormal ECG findings were classified into two groups: major ECG findings group, which fulfilled a pre-specified checklist to screen for principal structural and electrical cardiopathies, and minor ECG findings group showing other ECG changes. The major ECG findings group was referred for secondary diagnostic tests at a tertiary institution. Results: Of the 976 subjects screened, 252 (25.82%; CI95%, 23.17-28.66) had ECG findings. Of note, 17 (1.74%) had major findings and 235 (24.08%) had minor findings on ECG. The prevalence of cardiovascular pathology within the major ECG findings group was 35.29%. The prevalence of ECG abnormalities was significantly higher in males than in females (29% vs 20.9%, P<0.01). Conclusions: The prevalence of ECG findings in a youth population was 25.82%. There were significant gender differences. The inclusion of universal ECG screening, in addition to medical history, may increase the sensitivity of a cardiovascular screening program. Knowledge of the spectrum and prevalence of ECG findings and disease conditions would be pivotal in designing customized screening programs

Apolipoprotein E and Recovery from Traumatic Brain Injury

The outcome from traumatic brain injury (TBI) is variable and only partly explained by known prognostic factors. This is especially true for predicting long-term outcome. Genetic factors may influence the brain`s susceptibility to injury or capacity for repair and regeneration. To examine the association of apolipoproteinE (apoE) genotype with long-term outcome, hippocampal volumes and general brain atrophy, we determined the apoE genotype from 61 TBI patients who had been injured over on average 31 years earlier. The long-term outcome was evaluated with repeated neuropsychological testing and by applying various measures of everyday functioning and quality of life. Magnetic resonance imaging (MRI) based volumetric analyses of the hippocampus and lateral ventricles were performed. In the prospective study, the purpose was to examine the association between apoE genotype and visibility of traumatic brain lesions during the first year after TBI and the ability of apoE genotype, the Glasgow Coma Score (GCS), MRI findings and duration of posttraumatic amnesia (PTA) to predict the one-year outcome. Thirty-three patients with TBI were studied and the outcome was evaluated with the Head Injury Symptom Checklist (HISC) and the Glasgow Outcome Scale extended version (GOS-E) scores one year after the injury. MRI and apoE genotyping were carried out. After three decades, neither hippocampal nor lateral ventricle volumes differed significantly in those patients with the apoE ε4 allele vs those without this allele, but the TBI patients with the apoE ε4 allele showed significantly poorer general cognitive level than those without this allele. This decline was wholly accounted for by a subgroup of patients who had developed incident or clinical dementia. In the prospective study the apoE genotype was not associated with visible MRI changes or outcome. The duration of PTA and acute MRI were the best predictors of one-year outcome in TBI. A portion of the TBI patients with the apoE ε4 allele seem to be at risk of long-term cognitive decline. This association may involve mechanisms other than those responsible for the development of brain atrophy. The early MRI and PTA have an important role in assessing the injury severity and prognosis.

Sähköinen tarkastuslista rakennusteollisuuden laadunvalvonnan tukena

Rakennusteollisuus on tunnettu useita muita aloja hitaammasta uuden teknologian käyttöönotosta. Yleisesti käytössä on hyvin perinteinen paperia ja kynää hyödyntävä tiedontallennuskäytäntö. Paperin käytössä tiedon tallennusvälineenä on useita ongelmia kuten säilytettävyys ja hallittavuus, joista päästään eroon siirtymällä sähköiseen tiedon tallennukseen. Laadun varmistamiseksi voidaan käyttää tarkastuslistoja, jotka toimivat tarkastuksien suorittajan muistin tukena. Muutettaessa tarkastuslista sähköiseen muotoon, voidaan välttyä paperisen tarkastuslistan ongelmilta, kuten käsialan tunnistamiselta ja merkintätapojen vaihtelevuudelta. Tässä diplomityössä käsitellään rakennusteollisuuden laadunhallinnan nykytilaa sekä sähköisen tarkastuslistan käyttöä rakennusteollisuuden laadunvalvonnassa. Lisäksi esitellään prototyyppi sähköisestä tarkastuslistasta osana laadunvalvontaa. Sähköinen tarkastuslista toteutetaan dynaamisesti niin, että tarkastuslistojen pohjalta on mahdollista luoda käyttöliittymä kyseessä olevan listan mukaisesti päätelaitteelle. Sähköisen tarkastuslistan prototyyppi on toteutettu WWW-sovelluspalveluna (World Wide Web), joka mahdollistaa useiden erilaisten päätelaitteiden hyödyntämisen.

Informações essenciais para a caracterização de um sistema de análise em fluxo

Essential aspects for characterization of a flow-based analytical procedure or system are discussed in order to permit the composition of a checklist that will lead to a protocol for reporting results and systems in flow analysis. Aspects more related to chromatographic procedures are not considered. The intent is to present normalized proposals in the field of flow analysis for practitioners and developers.

Predictors and consequences of adherence to the treatment of pediatric patients with attention-deficit/hyperactivity disorder in Central Europe and East Asia.

PURPOSE: To assess baseline predictors and consequences of medication non-adherence in the treatment of pediatric patients with attention-deficit/hyperactivity disorder (ADHD) from Central Europe and East Asia. PATIENTS AND METHODS: Data for this post-hoc analysis were taken from a 1-year prospective, observational study that included a total of 1,068 newly-diagnosed pediatric patients with ADHD symptoms from Central Europe and East Asia. Medication adherence during the week prior to each visit was assessed by treating physicians using a 5-point Likert scale, and then dichotomized into either adherent or non-adherent. Clinical severity was measured by the Clinical Global Impressions-ADHD-Severity (CGI-ADHD) scale and the Child Symptom Inventory-4 (CSI-4) Checklist. Health-Related Quality of Life (HRQoL) was measured using the Child Health and Illness Profile-Child Edition (CHIP-CE). Regression analyses were used to assess baseline predictors of overall adherence during follow-up, and the impact of time-varying adherence on subsequent outcomes: response (defined as a decrease of at least 1 point in CGI), changes in CGI-ADHD, CSI-4, and the five dimensions of CHIP-CE. RESULTS: Of the 860 patients analyzed, 64.5% (71.6% in Central Europe and 55.5% in East Asia) were rated as adherent and 35.5% as non-adherent during follow-up. Being from East Asia was found to be a strong predictor of non-adherence. In East Asia, a family history of ADHD and parental emotional distress were associated with non-adherence, while having no other children living at home was associated with non-adherence in Central Europe as well as in the overall sample. Non-adherence was associated with poorer response and less improvement on CGI-ADHD and CSI-4, but not on CHIP-CE. CONCLUSION: Non-adherence to medication is common in the treatment of ADHD, particularly in East Asia. Non-adherence was associated with poorer response and less improvement in clinical severity. A limitation of this study is that medication adherence was assessed by the treating clinician using a single item question.