Net communication strategy planning and management

Tutkielman tavoitteena on selvittää kuinka suunnitella ja hallita tehokasta verkkoviestintää, joka vastaa kohdeyleisön ja palvelun ylläpitäjien kasvaviin vaatimuksiin. Tutkielma on normatiivinen tapaustutkimus, jonka tuloksena syntyy konstruktiivinen askelmalli kokonaisvaltaisen verkkoviestintäprojektin toteuttamiseen. Tutkimus esittää myös teoreettisesti merkittävän näkökulman verkkopalvelujen sisällön hallintaongelmien ratkaisemiseen. Tosielämän verkkoviestintäprojektin toteutusta seurataan TietoEnator Forestissa, jossa tutkielman kirjoittaja työskentelee. Tutkimusmateriaalina käytetään 11 TietoEnator Forestissa toteutettua haastattelua, TietoEnator konsernin dokumentaatiota ja osallistuvaa havainnointia. Haastattelulomake sisältää 13 avointa kysymystä, jotka käsittelevät verkkoviestintästrategian perusasioita. Tunnistetut verkkoviestinnän avainmenestystekijät ovat vahva sisäinen sitoutuminen hajautettuihin ylläpitorooleihin ja perinpohjainen asiakastarpeiden tunnistaminen. Teknisesti on tärkeää, että eritason verkkoympäristöt, Internet, Intranet ja Extranet, hallitaan samoilla sisällönhallinta työkaluilla. Näin pystytään rationalisoimaan ylläpitotoiminnot.

PREVENTION OF CHILLING INJURY IN 'TOMMY ATKINS' MANGOES PREVIOUSLY STORED AT 5 ºC, USING HEAT TREATMENT AND RADIATION UV (UV-C)

ABSTRACT The objective of this study was to evaluate the effect of heat treatment and ultraviolet radiation (UV-C) in the prevention of chilling injury in mangoes cv. Tommy Atkins previously stored or not under injury condition after their transference to ambient condition. Fruits were divided into groups: two were hydrothermally treated (46.1 ºC/90 min; 55 ºC/5 min) and two were exposed to UV-C radiation (1.14 kJ m-2; 2.28 kJ m-2). These groups were stored under chilling injury conditions (5 ºC for 14 days), as established in preliminary tests. Other untreated groups were stored at 12 ºC or 5 ºC. After the storage period, they were transferred to ambient conditions (21.9 ºC; 55% RH) and the quality was evaluated. All the data were submitted to multivariate analysis as the tool to verify the simultaneous effect of the treatments under the quality parameters. The multivariate analysis indicated that the hydrothermal treatments at 46.1 °C/90 min and 55 °C/5 min and the UV-C radiation at doses of 1.14 kJ m-2 and 2.28 kJ m-2 were effective in minimized the symptoms of chilling injury in mangoes ‘Tommy Atkins’ stored at 5 °C for 14 days. However, after their transference to environmental condition at 21.9 °C, only the UV-C kept this control, especially at a dose of 2.28 kJ m-2. This treatment did not prevent the development of the characteristic color or affected the normal ripening and allowed the conservation of fruit for a period of 14 days at 5 °C, plus seven days of storage at environmental condition, which corresponds to the shipping transportation plus the time for sale.

Prevalence of Ischemic Heart Disease and Management of Coronary Risk in Daily Clinical Practice: Results from a Mediterranean Cohort of HIV-Infected Patients

There are conflicting data on the prevalence of coronary events and the quality of the management of modifiable cardiovascular risk factors (CVRF) inHIV-infected patients. Methods.We performed a retrospective descriptive study to determine the prevalence of coronary events and to evaluate the management of CVRF in a Mediterranean cohort of 3760 HIV-1-infected patients from April 1983 through June 2011. Results.We identified 81 patients with a history of a coronary event (prevalence 2.15%); 83% of them suffered an acute myocardial infarction. At the time of the coronary event, CVRF were highly prevalent (60.5% hypertension, 48% dyslipidemia, and 16% diabetes mellitus).OtherCVRF, such as smoking, hypertension, lack of exercise, and body mass index, were not routinely assessed. After the coronary event, a significant decrease in total cholesterol ( � = 0.025) and LDLcholesterol ( � = 0.004) was observed. However, the percentage of patients whomaintained LDL-cholesterol > 100mg/dL remained stable (from 46% to 41%, � = 0.103). Patients using protease inhibitors associated with a favorable lipid profile increased over time ( � = 0.028). Conclusions.The prevalence of coronary events in our cohort is low. CVRF prevalence is high and theirmanagement is far from optimal. More aggressive interventions should be implemented to diminish cardiovascular risk in HIV-infected patients.

Preservation and Management of Added Value in Networked R&D environment

Tämä tutkielma käsittelee lisäarvon syntymistä, ylläpitämistä ja hallintaa verkostoi-tuneessa tuotekehitysympäristössä. Teemahaastattelu-menetelmää käyttäen, tavoitteena on tunnistaa ja kuvata ne prosessit, käytännöt ja toimintatavat, joissa kohdeyritys on onnistunut ja joissa lisäarvoa on syntynyt. Toinen keskeinen tavoite on löytää ongelmalliset alueet lisäarvon tuottamisessa ja analysoida, miksi nämä alueet ovat ongelmallisia. Käsitteiden arvo, arvoketju ja arvoverkosto, sekä viitekirjallisuuden esimerkkien perusteella muodostetaan teoreettinen viitekehys ja kuvataan niitä hyödyllisiä toimintatapoja ja käytäntöjä, joihin panostamalla lisäarvoa syntyy. Erityisesti informaatioteknologian alalla verkostoituminen ja arvoverkosto ovat yhä merkittävämpiä tuotekehityksen toimintatapoja, mihin horisontaalisen yhteistyön kehittyminen, globalisoituminen ja informaatioteknologian nopea kehitys on johtanut. Keskeisiä tuloksia ovat tarve yhtenäisempään, prosessinomaisempaan toimintatapaan ja liiketoimintaprosessien muokkaamiseen verkostoituneen T&K ympäristön vaatimusten mukaisesti. Myös tarve paremman näkyvyyden luomiseen sekä aktiviteettien hallintaan uudentyyppisen arvoverkoston vaatimusten mukaisesti korostui tuloksissa.

Aesthetic Breast Augmentation Mastopexy Followed by Post-surgical Pyoderma Gangrenosum (PSPG): Clinic, Treatment, and Review of the Literature.

INTRODUCTION: Pyoderma gangrenosum (PG) is a rare autoinflammatory neutrophilic ulcerative skin disease, often developing after a trauma or surgical wounds. In the literature there are several reports of post-surgical PG (PSPG) of the breast. The authors of this article experienced an impressive case of PSPG after an aesthetic breast augmentation mastopexy. PSPG is a rare but severe complication in this elective aesthetic surgical procedure. METHOD: A systematic review of the literature was performed, focusing on PSPG after aesthetic breast surgery (augmentation mammoplasty/mastopexy). The online databases Pubmed, Medline, and Cochrane were used and additionally a Google© search was conducted. We compared the data obtained from a systematic literature review to an index case of PSPG after esthetic augmentation mammoplasty. RESULTS: The literature search identified seven articles describing eight cases of PSPG after aesthetic breast surgery. In four of these cases augmentation mammoplasty had been carried out, in two cases mastopexy and in two cases augmentation mammoplasty and mastopexy (augmentation mastopexy). The patient we treated and describe in this paper underwent an augmentation mastopexy outside our clinic. Eight patients suffered from local disease, at the site of surgical wounds, one patient had disseminated disease. Leukocytosis was present in five cases (out of nine). Eight patients had received corticosteroid treatment, one patient refused such treatment. The duration of corticosteroid treatment was on average for 41 days (range 21-60 days). In all cases, the areola had been spared. Complete healing of PSPG was observed on average after 5 months (range 1.5 months-1 year). DISCUSSION: PSPG of the breast after aesthetic breast surgery is rare, but every plastic surgeon should consider this possibility, especially if skin disease develops post-surgery, mimicking wound infection that does not respond to broad-spectrum antibiotic treatment. CONCLUSION: Although the literature does not recommend this step, implant removal is recommended by the authors because bacterial wound infection normally cannot be ruled out definitely in the early stages of disease. Additional surgical intervention should be limited to the absolute necessary and performed only under adequate systemic immunosuppressive therapy. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Reducing Cardiovascular Mortality Through Prevention and Management of Raised Blood Pressure: A World Heart Federation Roadmap.

Prospective epidemiological data have shown that blood pressure has a graded, continuous adverse effect on the risk of various forms of CVD (including stroke, myocardial infarction, heart failure, peripheral arterial disease and end-stage renal disease). 'Raised blood pressure' is frequently considered to be any systolic blood pressure greater than 115 mmHg. It accounts for 45% of all heart disease deaths and 51% of all stroke-related deaths [1], which together are the biggest causes of morbidity and mortality worldwide [2,3,4]. Annually, there are >17 million deaths due to CVD worldwide, of which 9.4 million are attributable to complications of raised blood pressure. This highlights the importance of both high-risk and population-based strategies in blood pressure management and control.

Understanding academics' popular science publishing : institution culture and management style effects

Most universities and higher education systems have formally taken up a third mission, which involves various public outreach and engagement activities. Little is known regarding how higher education institutions' organisations interact with academic's level of public outreach. This article examines to which extent the perceptions academics have of their institutions' culture and management style, as well as some of their own individual and statutory characteristics interact with their level of public outreach. Using the Academic Profession in Europe comparative and quantitative research database, this article focuses on two countries on the extremities of the spectrum - Switzerland and the United Kingdom.

Eligibility to treatment and economic effect of the implementation of the new U.S. or European Society of Hypertension/European Society of Cardiology hypertension guidelines.

OBJECTIVE: To evaluate the population and economic impact of implementing the new Joint National Committee (JNC) or European Society of Hypertension (ESH)/European Society of Cardiology (ESC) hypertension guidelines in the Swiss population. METHODS: Cross-sectional, population-based sample (6708 participants) collected between 2003 and 2006 in the city of Lausanne, Switzerland. Blood pressure categories were defined according to both the JNC (JNC-7 and JNC-8) and the ESH/ESC (2007 and 2013) guidelines. RESULTS: The proportion of participants aged 35-60 years eligible for drug treatment was 25.6% [95% confidence interval (CI) 24.4-26.9%] and 24.8% (95% CI 23.6-26.0%) for the JNC-7 and the JNC-8 guidelines, respectively; for participants aged 60-75 years, the values were 62.3% (95% CI 60.1-64.5%) and 46.8% (95% CI 44.5-49.0%), respectively. Shifting from the JNC-7 to the JNC-8 guidelines would lead to an annual saving of 163.6 million Swiss francs (187.7 million US dollars or 134.5 million European euro). The proportion of participants aged 35-75 years without chronic kidney disease, diabetes mellitus or reported history of cardiovascular disease and eligible for treatment was 30.2% (95% CI 29.0-31.4%) for the ESH/ESC 2007 and 2013 guidelines. For participants with chronic kidney disease, diabetes mellitus or reported history of cardiovascular disease, the values were 73.6% (95% CI 70.8-76.3%) and 55.6% (95% CI 52.5-58.8%), respectively. Shifting from the ESH/ESC 2007 to the ESH/ESC 2013 guidelines would lead to an annual saving of 86.9 million Swiss francs (99.5 million US dollars or 71.4 million European euro). CONCLUSION: In Switzerland, shifting from the JNC-7 to the JNC-8 guidelines or from the ESH/ESC 2007 to the ESH/ESC 2013 guidelines would decrease the prevalence of patients eligible for treatment and increase the percentage of treated patients within blood pressure goals. Both strategies lead to potential savings in antihypertensive drug treatment.

Identification of imaging selection patterns in acute ischemic stroke patients and the influence on treatment and clinical trial enrollment decision making.

BACKGROUND AND PURPOSE: For the STroke Imaging Research (STIR) and VISTA-Imaging Investigators The purpose of this study was to collect precise information on the typical imaging decisions given specific clinical acute stroke scenarios. Stroke centers worldwide were surveyed regarding typical imaging used to work up representative acute stroke patients, make treatment decisions, and willingness to enroll in clinical trials. METHODS: STroke Imaging Research and Virtual International Stroke Trials Archive-Imaging circulated an online survey of clinical case vignettes through its website, the websites of national professional societies from multiple countries as well as through email distribution lists from STroke Imaging Research and participating societies. Survey responders were asked to select the typical imaging work-up for each clinical vignette presented. Actual images were not presented to the survey responders. Instead, the survey then displayed several types of imaging findings offered by the imaging strategy, and the responders selected the appropriate therapy and whether to enroll into a clinical trial considering time from onset, clinical presentation, and imaging findings. A follow-up survey focusing on 6 h from onset was conducted after the release of the positive endovascular trials. RESULTS: We received 548 responses from 35 countries including 282 individual centers; 78% of the centers originating from Australia, Brazil, France, Germany, Spain, United Kingdom, and United States. The specific onset windows presented influenced the type of imaging work-up selected more than the clinical scenario. Magnetic Resonance Imaging usage (27-28%) was substantial, in particular for wake-up stroke. Following the release of the positive trials, selection of perfusion imaging significantly increased for imaging strategy. CONCLUSIONS: Usage of vascular or perfusion imaging by Computed Tomography or Magnetic Resonance Imaging beyond just parenchymal imaging was the primary work-up (62-87%) across all clinical vignettes and time windows. Perfusion imaging with Computed Tomography or Magnetic Resonance Imaging was associated with increased probability of enrollment into clinical trials for 0-3 h. Following the release of the positive endovascular trials, selection of endovascular only treatment for 6 h increased across all clinical vignettes.

A retrospective study of deep sternal wound infections: clinical and microbiological characteristics, treatment, and risk factors for complications.

Deep sternal wound infection (DSWI) is a feared complication following cardiac surgery. This study describes clinical, microbiological, and treatment outcomes of DSWI and determines risk factors for complications. Of 55 patients with DSWI, 66% were male and mean age was 68.2years. Initial sternotomy was for coronary artery bypass graft in 49% of patients. Sternal debridement at mean 25.4±18.3days showed monomicrobial (94%), mainly Gram-positive infection. Secondary sternal wound infection (SSWI) occurred in 31% of patients, was mostly polymicrobial (71%), and was predominantly due to Gram-negative bacilli. Risk factors for SSWI were at least 1 revision surgery (odds ratio [OR] 4.8 [95% confidence interval {CI} 1.0-22.4], P=0.047), sternal closure by muscle flap (OR 4.6 [1.3-16.8], P=0.02), delayed sternal closure (mean 27 versus 14days, P=0.03), and use of vacuum-assisted closure device (100% versus 58%, P=0.008). Hospital stay was significantly longer in patients with SSWI (69days versus 48days, P=0.04).