Clinically meaningful parameters of progression and long-term outcome of Parkinson disease: An international consensus statement.

Parkinson disease (PD) is associated with a clinical course of variable duration, severity, and a combination of motor and non-motor features. Recent PD research has focused primarily on etiology rather than clinical progression and long-term outcomes. For the PD patient, caregivers, and clinicians, information on expected clinical progression and long-term outcomes is of great importance. Today, it remains largely unknown what factors influence long-term clinical progression and outcomes in PD; recent data indicate that the factors that increase the risk to develop PD differ, at least partly, from those that accelerate clinical progression and lead to worse outcomes. Prospective studies will be required to identify factors that influence progression and outcome. We suggest that data for such studies is collected during routine office visits in order to guarantee high external validity of such research. We report here the results of a consensus meeting of international movement disorder experts from the Genetic Epidemiology of Parkinson's Disease (GEO-PD) consortium, who convened to define which long-term outcomes are of interest to patients, caregivers and clinicians, and what is presently known about environmental or genetic factors influencing clinical progression or long-term outcomes in PD. We propose a panel of rating scales that collects a significant amount of phenotypic information, can be performed in the routine office visit and allows international standardization. Research into the progression and long-term outcomes of PD aims at providing individual prognostic information early, adapting treatment choices, and taking specific measures to provide care optimized to the individual patient's needs.

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.

Treatment of cancer with oral drugs: a position statement by the Spanish Society of Medical Oncology

Cancer treatment involves the participation of multiple medical specialties and, as our knowledge of the disease increases, this fact becomes even more apparent. The degree of multidisciplinarity is determined by several factors, which include the severity and type of disease, the increasing diversity in the available pharmacological and non-pharmacological therapies, and the range of specialists involved in cancer therapy, such as medical oncologists, radiotherapists, gynecologists, gastroenterologists, urologists, surgeons, and pneumologists, among others. Across Europe, the situation of cancer care can be variable due to the diversity of health systems, differences in drug reimbursement, and the degree of establishment of Medical Oncology as a medical specialty in the European Union states.

Liderazgo y dirección de empresas en el s. XXI

Peer-reviewed

Liderazgo y dirección de empresas en el s. XXI

Peer-reviewed

Mission de maitrise d’oeuvre urbaine la Castellane (Marseille 15eme)

Award-winning

Mission and development : Finnish Pentecostal, Lutheran and Orthodox mission agencies in development work in Kenya 1948 - 1989

År 1974 började den finska regeringen kanalisera pengar för utvecklingssamarbete genom medborgarorganisationer. Tre år senare och fram till år 1988 beviljade regeringen ett speciellt anslag specifikt för missionsorganisationers utvecklingsprojekt. De finska pingstvännerna, lutheranerna och de ortodoxa utvidgade samtliga sitt sociala arbete i Kenya med statens stöd. Deras projekt var likadana: alla byggde läroanstalter, utvecklade Kenyas hälsoservice och sysselsatte kenyaner. Olikheterna mellan pingstvännerna, lutheranerna och de ortodoxa blev tydliga genom diverse problem som de mötte inom ramen för utvecklingssamarbetet. Den finska pingströrelsen bestod av självständiga församlingar, och pingstvännerna måste omvandla sin takorganisation, Suomen Vapaa Ulkolähetys, så att utvecklingsprojekt blev en viktig gren av dess verksamhet. Lutheranerna som till en början hade sänt missionärer för att arbeta i den kenyanska kyrkans tjänst började i medlet av 1970-talet i ökande grad bygga sociala anstalter med statens pengar. Ett problem var att statens stöd varade endast för en begränsad tid och att den lutherska kyrkan i Kenya inte hade råd att överta dessa anstalter och täcka deras löpande kostnader i framtiden. De finska ortodoxa, för sin del, igångsatte sociala projekt i samarbete med de ortodoxa i Kenya. Under några år fick de dock lära sig att de inte kunde driva självständiga utvecklingsprojekt i Patriarkens i Alexandria maktsfär. Den finska ortodoxa missionen blev tvungen att underkasta sig ärkebiskopen i Nairobi. År för år beviljade den finska regeringen större anslag för missionsorganisationernas utvecklingsprojekt och statens ansvar för kostnaderna ökade från 50% till 60% år 1984. Intressant nog mottog både lutheranerna och de ortodoxa mindre statliga pengar för utvecklingssamarbete år 1989 än 1984. Däremot växte pingstvännernas utvecklingssamarbete i Kenya under hela 1980-talet. Eftersom pingstvännerna inte ville använda sina medlemmarnas pengar (som var avsedda för missionsverksamhet) till sociala projekt täckte de sin andel i utvecklingskostnaderna med pengar från utanförstående. Pingstvännerna utvecklade en omfatttande komersiell och även industriell verksamhet för att samla in pengar för sina utvecklingsprojekt.

From pioneering mission to autonomous church : Lutheran mission cooperation and church building in Thailand 1976-1994

Det lutherska missionsarbetet i Thailand startade inte förrän år 1976 då norska lutherska missionärer anlände till landet. Ett par år senare inledde Finska Missionssällskapet samarbete med norrmännen och med tiden anslöt sig även tre asiatiska lutherska kyrkor till missionssamarbetet i Thailand. Från första början var målet för missionsarbetet att grunda en självständig luthersk kyrka i Thailand. Detta skedde år 1994, 18 år efter att arbetet i Thailand hade inletts. I avhandlingen granskas vilka arbetsmetoder och verksamhetsformer som användes och hur grundandet av en självständig nationell luthersk kyrka förbereddes och förverkligades. I avhandlingen synas även den lutherska missionen i Thailand i förhållande till samtida internationellt missionstänkande och strömningar inom den kristna världsmissionen. Slutligen sätts den lutherska missionen i Thailand in i en thailändsk kulturell och religiös kontext.

CORPORATE SOCIAL RESPONSIBILITY from theory into financial statement: UPM-Kymmene Oyj

For number of reasons social responsibility in corporations has become a more essential part of business operations than before. Corporate social responsibility (CSR) is dealt with different means and aspects but the overall effects it has on organisations performance, communication and underline actions is indisputable. The thesis describes corporate social responsibility and the main objective was to observe how corporate social responsibility has developed in our case company with answering to main research question how CSR reporting has evolved in UPM-Kymmene Oyj? In addition following questions were also addressed: Is there a monetary value of CSR? What does proficient CSR report consist of? What does corporate social responsibility consist of? Qualitative research method, content analysis to be precise, was chosen and excessive literature study performed to find the theoretical back ground to perform the empirical part of the study. Data for the empirical part was collected from UPM-Kymmene Oyj financial data and annual reports. The study shows that UPM-Kymmene Oyj engagement to CSR and reporting of CSR matter have improved due time but still few managerial implications could be found. UPM-Kymmene Oyj economic key figures are only building shareholder value and stakeholders are identified in very general level. Also CSR data is scattered all over the annual report which causes problems to readers. The scientific importance of this thesis arises from the profound way CSR has been addressed in a holistic manner. Thus it is giving a good basis to understand the underlying reasons of CSR from society towards the organisation and vice versa.

Power cycling lifetime estimation of IGBT power modules based on chip temperature modeling

In this doctoral thesis, methods to estimate the expected power cycling life of power semiconductor modules based on chip temperature modeling are developed. Frequency converters operate under dynamic loads in most electric drives. The varying loads cause thermal expansion and contraction, which stresses the internal boundaries between the material layers in the power module. Eventually, the stress wears out the semiconductor modules. The wear-out cannot be detected by traditional temperature or current measurements inside the frequency converter. Therefore, it is important to develop a method to predict the end of the converter lifetime. The thesis concentrates on power-cycling-related failures of insulated gate bipolar transistors. Two types of power modules are discussed: a direct bonded copper (DBC) sandwich structure with and without a baseplate. Most common failure mechanisms are reviewed, and methods to improve the power cycling lifetime of the power modules are presented. Power cycling curves are determined for a module with a lead-free solder by accelerated power cycling tests. A lifetime model is selected and the parameters are updated based on the power cycling test results. According to the measurements, the factor of improvement in the power cycling lifetime of modern IGBT power modules is greater than 10 during the last decade. Also, it is noticed that a 10 C increase in the chip temperature cycle amplitude decreases the lifetime by 40%. A thermal model for the chip temperature estimation is developed. The model is based on power loss estimation of the chip from the output current of the frequency converter. The model is verified with a purpose-built test equipment, which allows simultaneous measurement and simulation of the chip temperature with an arbitrary load waveform. The measurement system is shown to be convenient for studying the thermal behavior of the chip. It is found that the thermal model has a 5 C accuracy in the temperature estimation. The temperature cycles that the power semiconductor chip has experienced are counted by the rainflow algorithm. The counted cycles are compared with the experimentally verified power cycling curves to estimate the life consumption based on the mission profile of the drive. The methods are validated by the lifetime estimation of a power module in a direct-driven wind turbine. The estimated lifetime of the IGBT power module in a direct-driven wind turbine is 15 000 years, if the turbine is located in south-eastern Finland.