Reporting on methods of subgroup analysis in clinical trials: a survey of four scientific journals

Results of subgroup analysis (SA) reported in randomized clinical trials (RCT) cannot be adequately interpreted without information about the methods used in the study design and the data analysis. Our aim was to show how often inaccurate or incomplete reports occur. First, we selected eight methodological aspects of SA on the basis of their importance to a reader in determining the confidence that should be placed in the author's conclusions regarding such analysis. Then, we reviewed the current practice of reporting these methodological aspects of SA in clinical trials in four leading journals, i.e., the New England Journal of Medicine, the Journal of the American Medical Association, the Lancet, and the American Journal of Public Health. Eight consecutive reports from each journal published after July 1, 1998 were included. Of the 32 trials surveyed, 17 (53%) had at least one SA. Overall, the proportion of RCT reporting a particular methodological aspect ranged from 23 to 94%. Information on whether the SA preceded/followed the analysis was reported in only 7 (41%) of the studies. Of the total possible number of items to be reported, NEJM, JAMA, Lancet and AJPH clearly mentioned 59, 67, 58 and 72%, respectively. We conclude that current reporting of SA in RCT is incomplete and inaccurate. The results of such SA may have harmful effects on treatment recommendations if accepted without judicious scrutiny. We recommend that editors improve the reporting of SA in RCT by giving authors a list of the important items to be reported.

Food system transition towards sustainability: Inside thoughts of pioneers

The objective of this Master’s Thesis is to find individuals’ inducements that assist innovation adoption in the framework of sustainable food system. The purpose of the thesis is to examine the reasons why individuals adopt sustainable approaches, and furthermore, to see by what means the transition to the more sustainable food system could be accelerated. The study’s focal point is on the micro level, even if the wider purpose is to accelerate the holistic change of food system in the near future. The study consists of a literature review and a qualitative research, which is actualized with semi-structured interviews. The results indicate that individuals adopt innovations based on their strong intrinsic motivation. The main inducements were environment-related and health-related aspects, and individual’s deep connection to the countryside. The effect of social circle and doing good actions with the consuming behavior were also highlighted. Strongest barriers to innovation adoption seem to be price sensitivity, lack of easiness, and lack of interest in food. The findings indicate also that the most significant means that could ease the individuals’ decision to adopt an innovation are health-related aspects, educating and learning, environmental aspects, and decreasing the prices. Although the theoretical part of the study highlights the effect of positive reinforcement, the empirical part neglects it.

Reporting of Green Supply Chain Management and Industrial Symbiosis

The purpose of this thesis is to examine how the reporting of operations related to green supply chain management and industrial symbiosis has evolved in UPM, Fortum and Kemira within the last ten years. The focus is on the improved operations, which are studied based on annual reports of these companies. The study provides a deeper understanding of the nature of green supply chain management and industrial symbiosis as well as the possibilites that their combination offers. The research is part of the DemaNET research project The study indicates that the environmental regulations and reporting standards have forced the studied companies to report their operations related to green supply chain management and industrial symbiosis more in detail during the last ten years. The operations related to green supply chain management in the studied companies are more common compared to operations related to industrial symbiosis. Often these two operations were also partially integrated, indicating a hybrid model. Even though firms often used hybrid models they still focused mainly on greening the internal operations rather than finding alternative ways for symbiosis outside the organization. The integration of green supply chain management and industrial symbiosis is most likely to occur when mutually beneficial relationships align the interests of all parties, thus resulting in the co-creation of value. The findings suggest that identifying mutual benefits and the flow of by-products are the ones that companies should give more attention to.

Pim-1 kinase inhibits the activation of reporter gene expression in Elk-1 and c-Fos reporting systems but not the endogenous gene expression: an artifact of the reporter gene assay by transient co-transfection

We have studied the molecular mechanism and signal transduction of pim-1, an oncogene encoding a serine-threonine kinase. This is a true oncogene which prolongs survival and inhibits apoptosis of hematopoietic cells. In order to determine whether the effects of Pim-1 occur by regulation of the mitogen-activated protein kinase pathway, we used a transcriptional reporter assay by transient co-transfection as a screening method. In this study, we found that Pim-1 inhibited the Elk-1 and NFkappaB transcriptional activities induced by activation of the mitogen-activated protein kinase cascade in reporter gene assays. However, Western blots showed that the induction of Elk-1-regulated expression of endogenous c-Fos was not affected by Pim-1. The phosphorylation and activation of neither Erk1/2 nor Elk-1 was influenced by Pim-1. Also, in the gel shift assay, the pattern of endogenous NFkappaB binding to its probe was not changed in any manner by Pim-1. These data indicate that Pim-1 does not regulate the activation of Erk1/2, Elk-1 or NFkappaB. These contrasting results suggest a pitfall of the transient co-transfection reporter assay in analyzing the regulation of transcription factors outside of the chromosome context. It ensures that results from reporter gene expression assay should be verified by study of endogenous gene expression.

Improving reporting and internal control with process thinking - case study in a multinational corporation

The aim of this Master’s Thesis is to find applicable methods from process management literature for improving reporting and internal control in a multinational corporation. The method of analysis is qualitative and the research is conducted as a case study. Empirical data collection is carried out through interviews and participating observation. The theoretical framework is built around reporting and guidance between parent company and subsidiary, searching for means to improve them from process thinking and applicable frameworks. In the thesis, the process of intercompany reporting in the case company is modelled, and its weak points, risks, and development targets are identified. The framework of critical success factors in process improvement is utilized in assessing the development targets. Also internal control is analyzed with the tools of process thinking. As a result of this thesis, suggestions for actions improving the reporting process and internal control are made to the case company, the most essential of which are ensuring top management’s awareness and commitment to improvement, creating guidelines and tools for internal control and creating and implementing improved intercompany reporting process.

Implementatiоn оf Sustainability-Оriented Innоvatiоns in Business - Studying Оrganizatiоnal and External Capabilities: Evidence frоm Pоland

The cоncept оf sustainability-оriented innоvatiоn is recent and still under researched. The aim оf the Thesis is tо cоntribute tо the field and investigate hоw dо cоmpanies оperating in Pоland apply sustainability-оriented innоvatiоn (SОI) tо their cоre business activities, what are the differences between variоus business fоrms оf оrganizatiоn in terms оf SОI, and what type оf capabilities facilitate implementatiоn оf SОI. Given early stage оf empirical research оn sustainability-оriented innоvatiоn, an explоratоry-descriptive case study research strategy was taken applying qualitative methоds. 6 interviews with managers and CEОs оf 4 cоmpanies lоcated in Warsaw were cоnducted. In additiоn, twо academic expert panels with specialists frоm University оf Lоdz and Lappeenranta University оf Technоlоgy were carried оut in оrder tо suppоrt the findings. The study fоund оut that in case оf cоmpanies which purpоse is tо create pоsitive impact and develоp sustainable prоducts оr services by using innоvative apprоaches, SОI activities are embedded in оrganizatiоnal culture and prоcess sо that it is difficult tо differentiate between main business activities and SОI. In the оther twо cases SОI practices were in line with cоre business activities thus reflected the main оperatiоns and were determined as a part оf CSR strategy. Activities are industry specific and are cоntingent upоn resоurces and capabilities pоssessed. Amоng list оf success factоrs management suppоrt, CEО’s persоnal values, dedicated and mоtivated team, investments in research and develоpment, оrganizatiоnal culture, nоn-hierarchical cоmmunicatiоns channels, empоwerment оf emplоyees, prоvisiоn оf time and space fоr failures were identified as key оrganizatiоnal capabilities facilitating integratiоn оf SОI practices. Whereas market demand, NGОs’ pressure, regulatiоns enfоrced, access tо external funding, netwоrking and cооperating present external оr cоllabоrative capabilities suppоrting implementatiоn оf sustainability оriented innоvatiоn in cоmpanies. SОI takes a systemic apprоach that drives the transfоrmatiоn tо becоme sustainable business embedding and integrating sоcial, envirоnmental and ecоnоmic value creatiоn tоgether.

Analyzing and Computing the Sustainability Gains of Building Automation

Smart home implementation in residential buildings promises to optimize energy usage and save significant amount of energy simply due to a better understanding of user's energy usage profile. Apart from the energy optimisation prospects of this technology, it also aims to guarantee occupants significant amount of comfort and remote control over home appliances both at home locations and at remote places. However, smart home investment just like any other kind of investment requires an adequate measurement and justification of the economic gains it could proffer before its realization. These economic gains could differ for different occupants due to their inherent behaviours and tendencies. Thus it is pertinent to investigate the various behaviours and tendencies of occupants in different domain of interests and to measure the value of the energy savings accrued by smart home implementations in these domains of interest in order to justify such economic gains. This thesis investigates two domains of interests (the rented apartment and owned apartment) for primarily two behavioural tendencies (Finland and Germany) obtained from observation and corroborated by conducted interviews to measure the payback time and Return on Investment (ROI) of their smart home implementations. Also, similar measures are obtained for identified Australian use case. The research finding reveals that building automation for the Finnish behavioural tendencies seems to proffers a better ROI and payback time for smart home implementations.

NEW BUSINESS MODELS – Sustainability as a main focus

A business model is a structure frame of an organization that can bring significant benefits and competitive advantage when structured properly. The aim of this paper was to observe and describe development of business models’ and identify factors and elements of a business model that are in a key role from the perspective of an organizational sustainability. One is striving to bring out in this thesis how should truly sustainable business model look like and what are main characteristics of it. Additionally, some recommendations that could be helpful in order to build sustainable and balanced business model in a company are presented in this work. The meaning was to make theoretical and in some extent practical acquaintance with such new business models as open business model and sustainable business model. Long-term sustainability achievement in a company was in a centric role and used as a main criteria when constructing sustainable business model structure. The main research question in this study aims to answer: What a firm should consider in order to develop profitable and sustainable business model? This study is qualitative in nature and it was conducted using content analyze as a main method of this research. The perspective of the target data in this study is an outlook of its producers of how sustainability is reached in an organization throw business model and which practices are important and has to be taken into account. The material was gathered mainly from secondary sources and the theoretical framework was outright built based on secondary data. The secondary data that have been mostly dissertations, academic writings, cases, academic journals and academic books have been analyzed from the point of view of sustainability perspective. As a result it became evident that a structure of a business model and its implementation along with a strategy is often what leads companies to success. However, for the most part, overall business environment decides and delimits how the most optimal business model should be constructed in order to be effective and sustainable. The evaluation of key factors and elements in business model leading organization to sustainability should be examined throw triple bottom line perspective, where key dimensions are environmental, social and economic. It was concluded that dimensions should be evaluated as equal in order to attain total long lasting sustainability, contradicting traditional perspective in business where profit production is seen as only main goal of a business.

Green Service Level Agreement under Sustainability Lens in IT Industry

Nowadays, when most of the business are moving forward to sustainability by providing or getting different services from different vendors, Service Level Agreement (SLA) becomes very important for both the business providers/vendors and as well as for users/customers. There are many ways to inform users/customers about various services with its inherent execution functionalities and even non-functional/Quality of Services (QoS) aspects through negotiating, evaluating or monitoring SLAs. However, these traditional SLA actually do not cover eco-efficient green issues or IT ethics issues for sustainability. That is why green SLA (GSLA) should come into play. GSLA is a formal agreement incorporating all the traditional commitments as well as green issues and ethics issues in IT business sectors. GSLA research would survey on different traditional SLA parameters for various services like as network, compute, storage and multimedia in IT business areas. At the same time, this survey could focus on finding the gaps and incorporation of these traditional SLA parameters with green issues for all these mentioned services. This research is mainly points on integration of green parameters in existing SLAs, defining GSLA with new green performance indicators and their measurable units. Finally, a GSLA template could define compiling all the green indicators such as recycling, radio-wave, toxic material usage, obsolescence indication, ICT product life cycles, energy cost etc for sustainable development. Moreover, people’s interaction and IT ethics issues such as security and privacy, user satisfaction, intellectual property right, user reliability, confidentiality etc could also need to add for proposing a new GSLA. However, integration of new and existing performance indicators in the proposed GSLA for sustainable development could be difficult for ICT engineers. Therefore, this research also discovers the management complexity of proposed green SLA through designing a general informational model and analyses of all the relationships, dependencies and effects between various newly identified services under sustainability pillars. However, sustainability could only be achieved through proper implementation of newly proposed GSLA, which largely depends on monitoring the performance of the green indicators. Therefore, this research focuses on monitoring and evaluating phase of GSLA indicators through the interactions with traditional basic SLA indicators, which would help to achieve proper implementation of future GSLA. Finally, this newly proposed GSLA informational model and monitoring aspects could definitely help different service providers/vendors to design their future business strategy in this new transitional sustainable society.

Improving oral healthcare in Scotland with special reference to sustainability and caries prevention

Brett Duane Improving oral healthcare in Scotland with special reference to sustainability and caries prevention University of Turku, Faculty of Medicine, Institute of Dentistry, Community Dentistry, Finnish Doctoral Program in Oral Sciences (FINDOS-Turku), Turku, Finland Annales Universitatis Turkuensis, Sarja- Ser. D, Medica-Odontologica. Painosalama Oy, Turku, Finland, 2015. Dentistry must provide sustainable, evidence-based, and prevention-focused care. In Scotland oral health prevention is delivered through the Childsmile programme, with an increasing use of high concentration fluoride toothpaste (HCFT). Compared with other countries there is little knowledge of xylitol prevention. The UK government has set strict carbon emission limits with which all national health services (NHS) must comply. The purpose of these studies was firstly to describe the Scottish national oral health prevention programme Childsmile (CS), to determine if the additional maternal use of xylitol (CS+X) was more effective at affecting the early colonisation of mutans streptococci (MS) than this programme alone; secondly to analyse trends in the prescribing and management of HCFT by dentists; and thirdly to analyse data from a dental service in order to improve its sustainability. In all, 182 mother/child pairs were selected on the basis of high maternal MS levels. Motherswere randomly allocated to a CS or CS+X group, with both groups receiving Childsmile. Theintervention group consumed xylitol three times a day, from when the child was 3 months until 24 months. Children were examined at age two to assess MS levels. In order to understand patterns of HCFT prescribing, a retrospective secondary data analysis of routine prescribing data for the years 2006-2012 was performed. To understand the sustainability of dental services, carbon accounting combined a top-down approach and a process analysis approach, followed by the use of Pollard’s decision model (used in other healthcare areas) to analyse and support sustainable service reconfiguration. Of the CS children, 17% were colonised with MS, compared with 5% of the CS+X group. This difference was not statistically significant (P=0.1744). The cost of HCFT prescribing increased fourteen-fold over five years, with 4% of dentists prescribing 70% of the total product. Travel (45%), procurement (36%) and building energy (18%) all contributed to the 1800 tonnes of carbon emissions produced by the service, around 4% of total NHS emissions. Using the analytical model, clinic utilisation rates improved by 56% and patient travel halved significantly reducing carbon emissions. It can be concluded that the Childsmile programme was effective in reducing the risk for MS transmission. HCFT is increasing in Scotland and needs to be managed. Dentistry has similar carbon emissions proportionally as the overall NHS, and the use of an analytic tool can be useful in helping identify these emissions. Key words: Sustainability, carbon emissions, xylitol, mutans streptococci, fluoride toothpaste, caries prevention.

Creating Value for Corporate Sustainability: Stakeholder Engagement

The thesis aims to build a coherent view and understanding of stakeholder engagement’s contribution to corporate sustainability value creation. Theory suggests that corporate sustainability relies on sustainable relationships between the firm and its multiple stakeholders. This study is qualitative and evidence is derived from integrative analysis of literature, secondary data and case study analysis. The findings from the interviews analysis supplement the framework developed as the results of the literature review. The results obtained throughout the thesis research imply that stakeholder engagement helps develop more thorough understandings of issues and alternative perspectives, which in turn facilitates the decision-making processes improvement. The improvement is also achieved through ethical analysis, by weighing the impact of firm’s decisions on all relevant groups. Therefore, clear communication and exchange of information also improve the acceptance of sustainability initiatives amongst stakeholders both in terms of building trust and managing expectations. As practical implications, this thesis presents organizational practices that can be employed by companies to support effective engagement with stakeholders. The described practices could enhance processes such as partnership and co-creation resulting in greater sustainable development.