Est-ce qu'en discuter fait la différence ? Opinions de jeunes adultes atteints de maladies chroniques après avoir été transférés vers des soins pour adultes [Does talking about it make a difference? Opinions of chronically ill young adults after being transferred to adult care].

1) Introduction: pour les jeunes souffrant de maladie chronique, l'objectif de la transition vers les soins pour adultes est d'optimiser leur fonctionnement et leur potentiel. Le but de cette étude pilote était d'évaluer si les jeunes adultes souffrant de maladie chronique jugeaient que le passage vers les soins adultes était plus facile lorsque la question de la transition avait été discutée au préalable avec leur pédiatre. 2) Matériel et méthodes: deux groupes de jeunes adultes atteints de maladie chronique ont été identifiés selon l'existence (n = 70) ou non (n = 22) d'une discussion préalable avec leur pédiatre à propos de la transition vers une prise en charge pour adultes. Ces deux groupes ont été comparés pour des variables démographiques et de santé. Les variables significatives en analyse bivariée ont été incluses dans une régression logistique descendante pas à pas. 3) Résultats: les jeunes adultes qui avaient discuté de la transition étaient significativement plus nombreux à se sentir prêts (72,9 % vs 45,5 %) et accompagnés (58,6 % vs 27,3 %) pour le transfert, à avoir consulté leur spécialiste pour adultes (60 % vs 31,8 %) et à voir leur médecin sans la présence de leurs parents (70 % vs 40,9 %). En analyse multivariée, seuls, le fait de se sentir accompagné (odds ratio ajustée [ORa] : 3,56) et celui d'avoir consulté leur spécialiste pour adultes (ORa : 4,14) étaient significatifs. 4) Conclusions: la préparation des jeunes souffrant de maladie chronique au transfert vers les soins pour adultes semble bénéfique. Cependant, le transfert lui-même n'est qu'une petite partie du concept beaucoup plus large de la transition vers la vie adulte. Une transition bien planifiée doit permettre à ces jeunes adultes d'atteindre tout leur potentiel. INTRODUCTION: The goal of transition in healthcare for young people with chronic illnesses is to maximize their functioning and potential. The purpose of this pilot study was to assess whether young adults with chronic illnesses found that the transition to adult care was easier when the transition was discussed in advance with their pediatric specialist. METHODS: Two groups were created according to whether patients had discussed (n=70) or not (n=22) the transition with their pediatric specialist and compared regarding demographic and health-related variables. All the significant variables at the bivariate level were included in a backward stepwise logistic regression. RESULTS: Youth who had discussed the transition were significantly more likely to feel ready for the transfer (72.9% vs 45.5%) and accompanied (58.6% vs 27. %) during transfer, to have consulted their specialist for adults (60.0% vs 31.8%), and seen their doctor without the presence of their parents (70.0% vs 40.9%). At the multivariate level, only feeling accompanied during transfer (adjusted odds ratio (aOR): 3.56) and having consulted their specialist for adults (aOR: 4.14) remained significant. CONCLUSIONS: Preparing chronically ill youths for transfer to adult care appears to be beneficial for them. However, transfer is only a small part of the much broader transition that is preparation for adult life. A well-planned transition should allow these young people to reach their full potential.

In vitro organogenesis of rangpur lime

Rangpur lime (Citrus limonia Osbeck) in vitro organogenesis was studied based on explant type and cytokinin culture media supplementation. Four explants types collected from epicotyl or hypocotyl regions of in vitro germinated seedlings were evaluated. The epicotyl-derived explants consisted of epicotyl segments and the hypocotyl-derived explants consisted of the entire hypocotyl segment, the hypocotyl segment attached to a cotyledon fragment, and the hypocotyl segment divided longitudinally. The explants were cultured on EME culture medium supplemented with benzylaminopurine (0, 0.5, 1.0, or 1.5 mg L-1). The evaluation was performed after 6 weeks. Best results considering both the explant responsiveness and number of shoots developed per explants were obtained when epicotyl segments-derived explants were evaluated. Considering the explant responsiveness of hypocotyl segments-derived explants no difference was detected between the entire hypocotyl segment and the hypocotyl segment attached to a cotyledon fragment. Moreover, the percentage of responsive explants decreased when hypocotyl segments divided longitudinally were tested. No difference was detected for the number of shoots developed per explant considering the three types of hypocotyl-derived explants. Culture media supplementation with BAP was not essential for Rangpur lime in vitro organogenesis. However, adventitious shoot development was stimulated in concentrations between 0.5 - 1.0 mg L-1.

Kestomagneettitahtikonekäytön soveltaminen paperiteollisuuden linjakäytöissä

Tässä työssä tutkitaan kestomagneettitahtimoottorin soveltuvuutta paperiteollisuuden linjakäyttöihin. Aluksi perehdytään taajuusohjatun kestomagneettitahtimoottorin häviöiden syntymiseen ja niiden jakautumiseen. Työssä esitellään kestomagneettitahtimoottorin koon valintaan vaikuttavia tekijöitä ja vertaillaan oikosulkumoottorin ja kestomagneettitahtimoottorin mitoituksen eroja. Lisäksi tarkasteltiin linjakäytön vaihtosuuntaajan ja syöttöryhmän mitoitusta, kun kestomagneettitahtimoottoria käytetään paperiteollisuuden linjakäytössä. Kestomagneettitahtimoottorin virran riippuvuutta kuormituksesta laskettiin ja mitattiin yhden kestomagneettitahtimoottorin virta eri kuormituksilla. Näin voitiin suorittaa vertailu laskennan ja todellisuuden välillä. Mittaus osoitti laskentatavan tarkkuuden. Selvityksessä löydettiin riittävän tarkka laskentatapa, jonka avulla voidaan määrittää linjakäytön invertterin koko.

Päähankkijan ja toimittajan kahdenvälinen yhteistyö

Tutkimuksen tarkoituksena on tutkia päähankkijan ja toimittajan kahdenvälistä yhteistyötä. Tutkimuskohteena on yhteistyösuhde, joka on jaettu kiinteään partnership-yhteistyöhön ja astetta löyhempään toimittajayhteistyöhön. Tavoitteena on selvittää kuinka läheinen yhteistyösuhde luodaan yritysten välille ja mitkä ovat ne motiivit jotka saavat hankkivan yrityksen tekemään ratkaisunsa valittavan yhteistyömuodon suhteen. Tutkielma on teoreettinen tutkimus. Tutkimusmenetelmä on kvalitatiivinen jossa aineiston kerääminen, käsittely ja analyysi lomittuvat toisiinsa eivätkä johtopäätökset perustu tilastollisiin menetelmiin. Tutkimuksessa todettiin rakennettavan yhteistyön asteen riippuvan toiminnon tärkeydestä. Tärkeimpien toimintojen ollessa kyseessä hankkiva yritys pyrkii kiinteään partnership tyyppiseen suhteeseen. Toimittajayhteistyösuhde rakennetaan strategisesti tärkeiden toimittajien ollessa kyseessä. Yhteistyömuotojen erona on toimittajan strategian integrointi päähankkijan kanssa sekä toimittajan integroiminen systemaattisesti päähankkijan sekä loppuasiakkaan logistisiin prosesseihin, joka kuuluu partnership –yhteistyöhön erotuksena toimittajayhteistyöstä.

Competence needs of global middle management

Tutkielman tavoitteena oli tarkastella henkilöstöjohdon ja linjajohdon näkemyksiä kansainvälisissä tehtävissä toimivan keskijohdon osaamistarpeista suurissa suomalaisissa vientiyrityksissä. Teemahaastatteluja tehtiin 12:ssa Suomen tärkeimpien vientialojen suurimmista yrityksistä. Kansainvälisissä tehtävissä toimivan keskijohdon osaamistarpeiden, kategorioihin jaoteltuna, nähtiin olevan: - - Tieto ja ymmärtäminen: asiakkaan liiketoiminta ja tarpeet, oma tuote ja prosessit, globaali toimintaympäristö, alaisten osaamistarpeet- - Asioiden ja ihmisten johtaminen: muutoksen johtaminen, asiakkuuksien hallinta, ajan hallinta, motivointi, monikulttuurisen tiimin johtaminen- - Vuorovaikutus: kielitaito, suhteiden luominen, viestin kohdentaminen- - Henkilökohtaiset ominaisuudet ja motivaatio: joustavuus, kulttuurinen herkkyys, epävarmuuden sietokyky, oppimishalu, erilaisuuden kunnioitus- - Tehtäväkohtainen osaaminen: kansainvälinen markkinointi, talous, myyntitaidot, tekninen asiantuntemus.

Vinouden huomioiva arvopapereiden hinnoittelumalli ja sen empiirinen testaaminen Suomen markkinoilla

Tutkimuksen tarkoituksena on tutkia osaketuottojen jakauman vinoutta ja sen mahdollisia vaikutuksia osakkeiden hinnoitteluun Suomen markkinoilla. Aineistona käytetään kuutta portfoliota jotka on muodostettu Suomen markkinoilla noteerattavista osakkeista ajanjaksolla 1.1.1987–31.12.2004. Osakkeet on jaettu portfolioihin markkina-arvon mukaan. Empiiriset tulokset osoittavat, että osaketuotot Suomen markkinoilla ovat positiivisesti vinoja mutta pääosin eivät merkitsevästi. Teoreettisen taustan perusteella olisi ollut odotettavaa, että vinoutta olisi ollut enemmän. Regressioanalyysillä ja kahta artikkelia replikoiden tutkittiin perinteisen ja vinouden sisältäviä CAPM-malleja. Odotettavissa oli, että perinteinen CAPM-malli suoriutuu huonommin kuin vinouden sisältävä. Regressio-analyysillä testatessa molemmat mallit suoriutuivat hyvin tuottojen selittämisessä, mutta vakiotermien perusteella kolmimomenttinen malli suoriutuisi paremmin. Regressiomallin ja artikkelin perusteella saadut betat olivat yhteneväisiä. Regressiomallin ja artikkelin perusteella saaduissa gam-moissa oli kuitenkin eroja ja niiden perusteella ei voida tehdä johtopäätöksiä. Regressiomalli näyttäisi kuitenkin huomioivan vinouden.

Comparison of application frameworks designed to support application extensibility

Reusability has become more popular factor in modern software engineering. This is mainly because object-orientation has brought methods that allow reusing more easily. Today more and more application developer thinks how they can reuse already existing applications in their work. If the developer wants to use existing components outside the current project, he can use design patterns, class libraries or frameworks. These provide solution for specific or general problems that has been already encountered. Application frameworks are collection of classes that provides base for the developer. Application frameworks are mostly implementation phase tools, but can also be used in application design. The main purpose of the frameworks is separate domain specific functionalities from the application specific. Usually the frameworks are divided into two categories: black and white box. Difference between those categories is the way the reuse is done. The application frameworks provide properties that can be examined and compared between different frameworks. These properties are: extensibility, reusability, modularity and scalability. These examine how framework will handle different platforms, changes in framework, increasing demand for resources, etc. Generally application frameworks do have these properties in good level. When comparing general purpose framework and more specific purpose framework, the main difference can be located in reusability of frameworks. It is mainly because the framework designed to specific domain can have constraints from external systems and resources. With general purpose framework these are set by the application developed based on the framework.

Long-term outcomes following functional endoscopic sinus surgery in Samter's triad.

OBJECTIVE: This study aimed to assess the long-term outcome of functional endoscopic sinus surgery for Samter's triad patients using an objective visual analogue scale and nasal endoscopy. METHOD: Using a retrospective database, 33 Samter's triad patients who underwent functional endoscopic sinus surgery were evaluated pre- and post-operatively between 1987 and 2007 in Hospital of La Chaux-de-Fonds, Switzerland. RESULTS: A total of 33 patients participated in the study, and the mean follow-up period was 11.6 years (range 1.2-20 years). Patients were divided into two groups based on visual analogue scale scores of the five parameters with the greatest difference in intensity of symptoms between the beginning and end of follow up. Group 1 included patients with a mean visual analogue scale score of 6 and below at the end of follow up and group 2 included patients with a mean visual analogue scale score of more than 6. The only statistically significant difference noted between the two groups was the endonasal findings: stage III-IV polyposis was present in 1 out of 24 patients (4 per cent) in group 1 and in 5 out of 9 patients (56 per cent) in group 2. CONCLUSION: The results of our study indicate that functional endoscopic sinus surgery helps stabilise disease progression. Stage III-IV polyposis had a significant adverse effect on long-term outcome.

Europeanization or Party Politics? Explaining Government Choice for Corporatist Concertation

This article assesses whether changes in government choice for policy concertation with trade unions and employers are better explained by international or domestic factors. We compare patterns of corporatist governance in a strongly Europeanized policy domain (labor migration policy) and in a weakly Europeanized policy domain (welfare state reforms) over the last 20 years in Austria and Switzerland. We show that there is no systematic difference in patterns of concertation between the two policy sectors and that factors linked to party politics play a bigger role in the choice of governments for concertation. If the base of party support for policies is divided, governments are more prone to resort to corporatist concertation as a way to build compromises for potentially controversial or unpopular policies. By contrast, ideologically cohesive majority coalitions are less prone to resort to concertation because they do not need to build compromises outside their base of party support.

Evaluating the impact of summer vacation on the visual acuity of AMD patients treated with ranibizumab.

PurposeTo evaluate the impact of traditional French summer vacation on visual acuity and spectral domain-optical coherence tomography (SD-OCT) of Wet AMD patients being treated with intravitreal Ranibizumab.MethodsThis was a consecutive, comparative, single-centre, prospective analysis. All patients who were being treated with intravitreal injection of 0.5 mg ranibizumab at Cergy Pontoise Hospital, Department of Ophthalmology between July 2013 and September 2014 were included. Patients were divided into two groups: (A) patients who skipped one ranibizumab intravitreal injection during holidays, and (B) patients who received injection during their holidays. Evaluations occurred prior to traditional holiday (baseline) and 2 months later, consisting of BCVA using ETDRS, and a complete ophthalmic examination that included slit-lamp biomicroscopy, fundus examination, fluorescein angiography (FA), indocyanine green angiography (ICGA), and spectral domain-optical coherence tomography (SD-OCT). All patients were being treated with PRN anti-VEGF regimen and criteria for reinjection included a visual acuity loss >5 ETDRS letters and/or an increase of central retinal thickness, presence of subretinal fluid, intraretinal fluid, or pigment epithelium detachment. If reinjection criteria were not met, patients were advised to return in 4 weeks.ResultsThe mean visual acuity change was -0.071±0.149 (LogMAR) in group A and +0.003±0.178 in group B (P=0.041). At the second visit (2 months after preholidays visit), 61.8% of patients in group A had SRF and/or intraretinal cysts, and only 27.6% of patients in group B. There was a significant difference in the persistence of fluid between the two groups (P=0.007, χ(2)-test).ConclusionThis cases series demonstrated the detrimental impact of holidays on visual acuity in patients treated with ranibizumab for AMD, which, in spite of their treatment regimen, still leave in vacation. Therefore, it is important to convey the message of treatment adherence to patients, despite their need of holidays.

Mergers and difference-in-difference estimator : why firms do not increase prices?

Difference-in-Difference (DiD) methods are being increasingly used to analyze the impact of mergers on pricing and other market equilibrium outcomes. Using evidence from an exogenous merger between two retail gasoline companies in a specific market in Spain, this paper shows how concentration did not lead to a price increase. In fact, the conjectural variation model concludes that the existence of a collusive agreement before and after the merger accounts for this result, rather than the existence of efficient gains. This result may explain empirical evidence reported in the literature according to which mergers between firms do not have significant effects on prices.

The difference of disease perception by juvenile idiopathic arthritis patients and their parents : analysis of the JAMAR questionnaire.

BACKGROUND: The JAMAR (Juvenile Arthritis Multidimensional Assessment Report) has been developed to evaluate the perception of the patient and his parents on different items: well-being, pain, functional status, quality of life, disease activity, disease course, side effects of medication, therapeutic compliance and satisfaction with illness outcome. Our aim was to compare disease's perception by JIA patients and their parents. METHODS: We included into the study 100 consecutive patients over 7 years of age. We asked both parent and child to complete the JAMAR questionnaire. For each patient we recorded demographic and disease related data. We examined the level of disagreement between children and parents for the quantitative items of the JAMAR: VAS Pain, VAS Disease Activity, VAS Well Being, Juvenile Arthritis Functional Score, HRQoL. Then we looked for a relation between discordance-rate and demographic and clinical variables. RESULTS: Children and parents' median scores for all five items were similar. Individual dyads agreement was low, with a large amount of pairs (80) discordant for at least one item. We found higher MD VAS and JADAS in more discordant dyads, suggesting that when the disease is more active discordance between child and parent increase. CONCLUSION: The JAMAR questionnaire is an important tool that helps clinicians to detect divergent child and parent's disease perceptions. It is essential that both patients and parents fill the JAMAR questionnaire for a complete clinical and psychosocial evaluation.

Comparison of Griffiths-II and Bayley-II tests for the developmental assessment of high-risk infants.

INTRODUCTION: Two important risk factors for abnormal neurodevelopment are preterm birth and neonatal hypoxic ischemic encephalopathy. The new revisions of Griffiths Mental Development Scale (Griffiths-II, [1996]) and the Bayley Scales of Infant Development (BSID-II, [1993]) are two of the most frequently used developmental diagnostics tests. The Griffiths-II is divided into five subscales and a global development quotient (QD), and the BSID-II is divided into two scales, the Mental scale (MDI) and the Psychomotor scale (PDI). The main objective of this research was to establish the extent to which developmental diagnoses obtained using the new revisions of these two tests are comparable for a given child. MATERIAL AND METHODS: Retrospective study of 18-months-old high-risk children examined with both tests in the follow-up Unit of the Clinic of Neonatology of our tertiary care university Hospital between 2011 and 2012. To determine the concurrent validity of the two tests paired t-tests and Pearson product-moment correlation coefficients were computed. Using the BSID-II as a gold standard, the performance of the Griffiths-II was analyzed with receiver operating curves. RESULTS: 61 patients (80.3% preterm, 14.7% neonatal asphyxia) were examined. For the BSID-II the MDI mean was 96.21 (range 67-133) and the PDI mean was 87.72 (range 49-114). For the Griffiths-II, the QD mean was 96.95 (range 60-124), the locomotors subscale mean was 92.57 (range 49-119). The score of the Griffiths locomotors subscale was significantly higher than the PDI (p<0.001). Between the Griffiths-II QD and the BSID-II MDI no significant difference was found, and the area under the curve was 0.93, showing good validity. All correlations were high and significant with a Pearson product-moment correlation coefficient >0.8. CONCLUSIONS: The meaning of the results for a given child was the same for the two tests. Two scores were interchangeable, the Griffiths-II QD and the BSID-II MDI.

Development of Color Difference Equations Matching to Human Vision System

Research on color difference evaluation has been active in recent thirty years. Several color difference formulas were developed for industrial applications. The aims of this thesis are to develop the color density which is denoted by comb g and to propose the color density based chromaticity difference formulas. Color density is derived from the discrimination ellipse parameters and color positions in the xy , xyY and CIELAB color spaces, and the color based chromaticity difference formulas are compared with the line element formulas and CIE 2000 color difference formulas. As a result of the thesis, color density represents the perceived color difference accurately, and it could be used to characterize a color by the attribute of perceived color difference from this color.