Online information seeking by patients with bipolar disorder:results from an international multisite survey

Background: Information seeking is an important coping mechanism for dealing with chronic illness. Despite a growing number of mental health websites, there is little understanding of how patients with bipolar disorder use the Internet to seek information. Methods: A 39 question, paper-based, anonymous survey, translated into 12 languages, was completed by 1222 patients in 17 countries as a convenience sample between March 2014 and January 2016. All patients had a diagnosis of bipolar disorder from a psychiatrist. Data were analyzed using descriptive statistics and generalized estimating equations to account for correlated data. Results: 976 (81 % of 1212 valid responses) of the patients used the Internet, and of these 750 (77 %) looked for information on bipolar disorder. When looking online for information, 89 % used a computer rather than a smartphone, and 79 % started with a general search engine. The primary reasons for searching were drug side effects (51 %), to learn anonymously (43 %), and for help coping (39 %). About 1/3 rated their search skills as expert, and 2/3 as basic or intermediate. 59 % preferred a website on mental illness and 33 % preferred Wikipedia. Only 20 % read or participated in online support groups. Most patients (62 %) searched a couple times a year. Online information seeking helped about 2/3 to cope (41 % of the entire sample). About 2/3 did not discuss Internet findings with their doctor. Conclusion: Online information seeking helps many patients to cope although alternative information sources remain important. Most patients do not discuss Internet findings with their doctor, and concern remains about the quality of online information especially related to prescription drugs. Patients may not rate search skills accurately, and may not understand limitations of online privacy. More patient education about online information searching is needed and physicians should recommend a few high quality websites.

Holocene precipitation change in different monsoon sub-regions (time-slices and transient data) simulated by different global climate models, with links to model results

The recently proposed global monsoon hypothesis interprets monsoon systems as part of one global-scale atmospheric overturning circulation, implying a connection between the regional monsoon systems and an in-phase behaviour of all northern hemispheric monsoons on annual timescales (Trenberth et al., 2000). Whether this concept can be applied to past climates and variability on longer timescales is still under debate, because the monsoon systems exhibit different regional characteristics such as different seasonality (i.e. onset, peak, and withdrawal). To investigate the interconnection of different monsoon systems during the pre-industrial Holocene, five transient global climate model simulations have been analysed with respect to the rainfall trend and variability in different sub-domains of the Afro-Asian monsoon region. Our analysis suggests that on millennial timescales with varying orbital forcing, the monsoons do not behave as a tightly connected global system. According to the models, the Indian and North African monsoons are coupled, showing similar rainfall trend and moderate correlation in rainfall variability in all models. The East Asian monsoon changes independently during the Holocene. The dissimilarities in the seasonality of the monsoon sub-systems lead to a stronger response of the North African and Indian monsoon systems to the Holocene insolation forcing than of the East Asian monsoon and affect the seasonal distribution of Holocene rainfall variations. Within the Indian and North African monsoon domain, precipitation solely changes during the summer months, showing a decreasing Holocene precipitation trend. In the East Asian monsoon region, the precipitation signal is determined by an increasing precipitation trend during spring and a decreasing precipitation change during summer, partly balancing each other. A synthesis of reconstructions and the model results do not reveal an impact of the different seasonality on the timing of the Holocene rainfall optimum in the different sub-monsoon systems. They rather indicate locally inhomogeneous rainfall changes and show, that single palaeo-records should not be used to characterise the rainfall change and monsoon evolution for entire monsoon sub-systems.

Modelling the effectiveness of grass buffer strips in managing muddy floods under a changing climate

Muddy floods occur when rainfall generates runoff on agricultural land, detaching and transporting sediment into the surrounding natural and built environment. In the Belgian Loess Belt, muddy floods occur regularly and lead to considerable economic costs associated with damage to property and infrastructure. Mitigation measures designed to manage the problem have been tested in a pilot area within Flanders and were found to be cost-effective within three years. This study assesses whether these mitigation measures will remain effective under a changing climate. To test this, the Water Erosion Prediction Project (WEPP) model was used to examine muddy flooding diagnostics (precipitation, runoff, soil loss and sediment yield) for a case study hillslope in Flanders where grass buffer strips are currently used as a mitigation measure. The model was run for present day conditions and then under 33 future site-specific climate scenarios. These future scenarios were generated from three earth system models driven by four representative concentration pathways and downscaled using quantile mapping and the weather generator CLIGEN. Results reveal that under the majority of future scenarios, muddy flooding diagnostics are projected to increase, mostly as a consequence of large scale precipitation events rather than mean changes. The magnitude of muddy flood events for a given return period is also generally projected to increase. These findings indicate that present day mitigation measures may have a reduced capacity to manage muddy flooding given the changes imposed by a warming climate with an enhanced hydrological cycle. Revisions to the design of existing mitigation measures within existing policy frameworks are considered the most effective way to account for the impacts of climate change in future mitigation planning. 

Managerial skills required by innovative and technology-based firms

This paper aims to investigate the Business Administration professional profile specifically required to manage innovative and high technology-based companies. It is a qualitative study outlined by an exploratory-descriptive research, supported by questionnaires and interviews addressed to a sample of executives of technology-based companies, located in São Paulo metropolitan region, Brazil. Accordingly, modular innovation arises from the existence of an architectural knowledge improved in association with the conceptually destroyed knowledge's component, meaning that architectural innovation arises from an improvement in the knowledge of the parties allied to the architectural knowledge's destruction. Results show that managers see innovation as one essential pillar for competitiveness and commonly associate innovation with team expertise related with the structure for this purpose. However, to instill innovation as an organizational discipline, it is necessary to redesign organizational processes, namely those considered critical to innovate. The company must revise its management model aiming to emphasize innovative behavior, which means readiness to respond to external environment change's requirements. Moreover, once it is necessary to change the manager's mindset about innovation, higher education institutions also have to adapt their Business Administration courses according to both changes, essentially concerning a more dynamic and more diffuse business environment in comparison to their curricular contents. The institutional pragmatism generates professionals who reach the job market with a historical and non-managerial overview on innovation. Nevertheless, results highlight that attitude is more appreciated than knowledge, or business management skills, what makes managerial behavior a key element in the innovation process in technology-based firms.

The Changing Relationship between Supervisors and Subordinates: How Managing This Relationship Evolves over Time

Understanding how the relationship between a subordinate and manager develops over time has been a critical matter both for academics and for business. In both academic journals and industry publications, some writers have argued that the relationship is driven by perceptions of fairness and treatment, and that developing the relationship can lead to better performance. Others have argued that higher performers get better treatment and resources, which results in superior relationships with their managers. There is really no clear answer of what comes first—perceptions of fairness, satisfaction with the supervisor, or job performance—and which leads to which.

Managing Rentals with Usage-Based Loss

Motivated by new and innovative rental business models, this paper develops a novel discrete-time model of a rental operation with random loss of inventory due to customer use. The inventory level is chosen before the start of a finite rental season, and customers not immediately served are lost. Our analysis framework uses stochastic comparisons of sample paths to derive structural results that hold under good generality for demands, rental durations, and rental unit lifetimes. Considering different \recirculation" rules | i.e., which rental unit to choose to meet each demand | we prove the concavity of the expected profit function and identify the optimal recirculation rule. A numerical study clarifies when considering rental unit loss and recirculation rules matters most for the inventory decision: Accounting for rental unit loss can increase the expected profit by 7% for a single season and becomes even more important as the time horizon lengthens. We also observe that the optimal inventory level in response to increasing loss probability is non-monotonic. Finally, we show that choosing the optimal recirculation rule over another simple policy allows more rental units to be profitably added, and the profit-maximizing service level increases by up to 6 percentage points.

Adolescent boys’ health : managing emotions, masculinities and subjective social status

The health of adolescent boys is complex and surprisingly little is known about how adolescent boys perceive, conceptualise and experience their health. Thus, the overall aim of this thesis was to explore adolescent boys’ perceptions and experiences of health, emotions, masculinity and subjective social status (SSS). This thesis consists of a qualitative, a quantitative and a mixed methods study. The qualitative study aimed to explore how adolescent boys understand the concept of health and what they find important for its achievement. Furthermore, the adolescent boys’ views of masculinity, emotion management and their potential effects on wellbeing were explored. For this purpose, individual interviews were conducted with 33 adolescent boys aged 16-17 years. The quantitative study aimed to investigate the associations between pride, shame and health in adolescence. Data were collected through a cross-sectional postal survey with 705 adolescents. The purpose of the mixed methods study was to investigate associations between SSS in school, socioeconomic status (SES) and self-rated health (SRH), and to explore the concept of SSS in school. Cross-sectional data were combined with interview data in which the meaning of SSS was further explored. Individual interviews with 35 adolescents aged 17-18 years were conducted. In the qualitative study, data were analysed using Grounded Theory. In the quantitative study, statistical analyses (e.g., chi-square test and uni- and multivariable logistic regression analyses) were performed. In the mixed method study, a combination of statistical analyses and thematic network analysis was applied. The results showed that there was a complexity in how the adolescent boys viewed, experienced, dealt with and valued health. On a conceptual level, they perceived health as holistic but when dealing with difficult emotions, they were prone to separate the body from the mind. Thus, the adolescent boys experienced a difference between health as a concept and health as an experience (paper I). Concerning emotional orientation in masculinity, two main categories of masculine conceptions were identified: a gender-normative masculinity and a non-gender-normative masculinity (paper II). Gender-normative masculinity comprised two seemingly opposite emotional masculinity orientations, one towards toughness and the other towards sensitivity, both of which were highly influenced by contextual and situational group norms and demands, despite that their expressions are in contrast to each other. Non-gender-normative masculinity included an orientation towards sincerity, emphasising the personal values of the boys. Emotions were expressed more independently of peer group norms. The findings suggest that different masculinities and the expression of emotions are intricately intertwined and that managing emotions is vital for wellbeing. The present findings also showed that both shame and pride were significantly associated with SRH, and furthermore, that there seems to be a protective effect of experiencing pride for health (paper III). The results also demonstrated that SSS is strongly related to SRH, and high SRH is related to high SSS, and further that the positioning was done in a gendered space (paper IV). Results from all studies suggest that the emotional and relational aspects, as well as perceived SSS, were strongly related to SRH. Positive emotions, trustful relationships and having a sense of belonging were important factors for health and pride was an important emotion protecting health. Physical health, on the other hand, had a more subordinated value, but the body was experienced as an important tool to achieve health. Even though health was mainly perceived in a holistic manner by the boys, there were boys who were prone to dichotomise the health experience into a mind-body dualism when having to deal with difficult emotions. In conclusion, this thesis demonstrates that young, masculine health is largely experienced through emotions and relationships between individuals and their contexts affected by gendered practices. Health is to feel and function well in mind and body and to have trusting relationships. The results support theories on health as a social construction of interconnected processes. Having confidence in self-esteem, access to trustful relationships and the courage to resist traditional masculine norms while still reinforcing and maintaining social status are all conducive to good health. Researchers as well as professionals need to consider the complexity of adolescent boys’ health in which norms, values, relationships and gender form its social determinants. Those working with young boys should encourage them to integrate physical, social and emotional aspects of health into an interconnected and holistic experience.

Understanding of genetic test results for osteogenesis imperfecta by attorneys and child welfare workers in non-accidental injury cases

Thesis (Ph.D.)--University of Washington, 2016-08

Managing and utilizing information flow for new products’ periodic account sales process

The goal was to understand, document and module how information is currently flown internally in the largest dairy organization in Finland. The organization has undergone radical changes in the past years due to economic sanctions between European Union and Russia. Therefore, organization’s ultimate goal would be to continue its growth through managing its sales process more efficiently. The thesis consists of a literature review and an empirical part. The literature review consists of knowledge management and process modeling theories. First, the knowledge management discusses how data, information and knowledge are exchanged in the process. Knowledge management models and processes are describing how knowledge is created, exchanged and can be managed in an organization. Secondly, the process modeling is responsible for visualizing information flow through discussion of modeling approaches and presenting different methods and techniques. Finally, process’ documentation procedure was presented. In the end, a constructive research approach was used in order to identify process’ related problems and bottlenecks. Therefore, possible solutions were presented based on this approach. The empirical part of the study is based on 37 interviews, organization’s internal data sources and theoretical framework. The acquired data and information were used to document and to module the sales process in question with a flowchart diagram. Results are conducted through construction of the flowchart diagram and analysis of the documentation. In fact, answers to research questions are derived from empirical and theoretical parts. In the end, 14 problems and two bottlenecks were identified in the process. The most important problems are related to approach and/or standardization for information sharing, insufficient information technology tool utilization and lack of systematization of documentation. The bottlenecks are caused by the alarming amount of changes to files after their deadlines.

Speech by Mr. Alban Sandi Bonilla, Dean, Faculty of Arts at the Inauguration of Professional Lecture "Managing Information in Specialized Areas in Costa Rican

Friends: Although we have not devoted special sessions to discuss the matter, the truth is that in some informal occasions we talked lightly about the relevance of the School of Library, Documentation and Information is at the Faculty of Arts. We have consistently defined our School Faculty as a humanist. The human reality in all its modes of symbolic production is the object of study that brings us together as an area of knowledge. A school is that, a major academic unit, which it brings together different disciplines deserve epistemological affinity for joint development. Cooperation, ease of interdisciplinary association are elements that justify the existence of the faculties. And our conversations, I insist, casual and light, have led us to establish two positions may seem superficially divergent, but are not. The Library mates look as techniques themselves, and feel that can be placed almost anywhere Faculty, and at first glance does not explain its presence in a humanities faculty. Let me turn away from this self-image.

Screening of esophageal varices by esophageal capsule endoscopy: results of a French multicenter prospective study

International audience

The problem posed by exam choice on the comparability of results in the Finnish matriculation examination

The article focuses on the upper secondary matriculation examination in Finland as a school leaving and university entrance examination. The presented research addresses the question of whether increased choice of the subject-specific examinations has the potential to undermine the comparability of examination results and to direct students’ choices not only in the examination but already beforehand at school. The authors refer to Finland’s tradition of more than 160 years of a national examination connecting the academic track of upper secondary schools with universities. The authors explain the Finnish system by describing the adoption of a course-based (vs. class- or year-based) curriculum for the three-year upper secondary education and the subsequent reforms in the matriculation examination. This increases students’ choices considerably with regard to the subject-specific exams included in the examination (a minimum of four). As a result, high-achieving students compete against each other in the more demanding subjects while the less able share the same normal distribution of grades in the less demanding subjects. As a consequence, students tend to strategic exam-planning, which in turn affects their study choices at school, often to the detriment of the more demanding subjects and, subsequently, of students’ career opportunities, endangering the traditional national objective of an all-round pre-academic upper secondary education. This contribution provides an overview of Finnish upper secondary education and of the matriculation examination (cf. Klein, 2013) while studying three separate but related issues by using data from several years of Finnish matriculation results: the relation of the matriculation examination and the curriculum; the problems of comparability vis-à-vis university entry due to the increased choice within the examination; the relations between students’ examination choices and their course selection and achievement during upper secondary school. (DIPF/Orig.)