Inventory and description of disease management programs in Switzerland

Background: Disease management, a system of coordinated health care interventions for populations with chronic diseases in which patient self-care is a key aspect, has been shown to be effective for several conditions. Little is known on the supply of disease management programs in Switzerland. Objectives: To systematically search, record and evaluate data on existing disease management programs in Switzerland. Methods: Programs met our operational definition of disease management if their interventions targeted a chronic disease, included a multidisciplinary team and lasted at least 6 months. To find existing programs, we searched Swiss official websites, Swiss web-pages using Google, medical electronic database (Medline), and checked references from selected documents. We also contacted personally known individuals, those identified as possibly working in the field, individuals working in major Swiss health insurance companies and people recommended by previously contacted persons (snow ball strategy). We developed an extraction grid and collected information pertaining to the following 8 domains: patient population, intervention recipient, intervention content, delivery personnel, method of communication, intensity and complexity, environment and clinical outcomes (measures?). Results: We identified 8 programs fulfilling our operational definition of disease management. Programs targeted patients with diabetes, hypertension, heart failure, obesity, alcohol dependence, psychiatric disorders or breast cancer, and were mainly directed towards patients. The interventions were multifaceted and included education in almost all cases. Half of the programs included regularly scheduled follow-up, by phone in 3 instances. Healthcare professionals involved were physicians, nurses, case managers, social workers, psychologists and dietitians. None fulfilled the 6 criteria established by the Disease Management Association of America. Conclusions: Our study shows that disease management programs, in a country with universal health insurance coverage and little incentive to develop new healthcare strategies, are scarce, although we may have missed existing programs. Nonetheless, those already implemented are very interesting and rather comprehensive. Appropriate evaluation of these programs should be performed in order to build upon them and try to design a generic disease management framework suited to the Swiss healthcare system.

Opposite clinical phenotypes of glucokinase disease: Description of a novel activating mutation and contiguous inactivating mutations in human glucokinase (GCK) gene.

Glucokinase is essential for glucose-stimulated insulin release from the pancreatic beta-cell, serving as glucose sensor in humans. Inactivating or activating mutations of glucokinase lead to different forms of glucokinase disease, i.e. GCK-monogenic diabetes of youth, permanent neonatal diabetes (inactivating mutations), and congenital hyperinsulinism, respectively. Here we present a novel glucokinase gene (GCK)-activating mutation (p.E442K) found in an infant with neonatal hypoglycemia (1.5 mmol/liter) and in two other family members suffering from recurrent hypoglycemic episodes in their childhood and adult life. In contrast to the severe clinical presentation in the index case, functional studies showed only a slight activation of the protein (relative activity index of 3.3). We also report on functional studies of two inactivating mutations of the GCK (p.E440G and p.S441W), contiguous to the activating one, that lead to monogenic diabetes of youth. Interestingly, adult family members carrying the GCK pE440G mutation show an unusually heterogeneous and progressive diabetic phenotype, a feature not typical of GCK-monogenic diabetes of youth. In summary, we identified a novel activating GCK mutation that although being associated with severe neonatal hypoglycemia is characterized by the mildest activation of the glucokinase enzyme of all previously reported.

Semantic data integration in a newspaper content management system

A newspaper content management system has to deal with a very heterogeneous information space as the experience in the Diari Segre newspaper has shown us. The greatest problem is to harmonise the different ways the involved users (journalist, archivists...) structure the newspaper information space, i.e. news, topics, headlines, etc. Our approach is based on ontology and differentiated universes of discourse (UoD). Users interact with the system and, from this interaction, integration rules are derived. These rules are based on Description Logic ontological relations for subsumption and equivalence. They relate the different UoD and produce a shared conceptualisation of the newspaper information domain.

Content value chains modelling using a copyright ontology

Existing digital rights management (DRM) systems, initiatives like Creative Commons or research works as some digital rights ontologies provide limited support for content value chains modelling and management. This is becoming a critical issue as content markets start to profit from the possibilities of digital networks and the World Wide Web. The objective is to support the whole copyrighted content value chain across enterprise or business niches boundaries. Our proposal provides a framework that accommodates copyright law and a rich creation model in order to cope with all the creation life cycle stages. The dynamic aspects of value chains are modelled using a hybrid approach that combines ontology-based and rule-based mechanisms. The ontology implementation is based on Web Ontology Language and Description Logic (OWL-DL) reasoners, are directly used for license checking. On the other hand, for more complex aspects of the dynamics of content value chains, rule languages are the choice.

Business Benefits of Content Management

Hyvällä sisällönhallinnalla on mahdollista vaikuttaa myönteisesti liiketoiminnalliseen tulokseen, jos sisällönhallinnan eri vaikutusmahdollisuudet tunnistetaan. Kun organisaatiossa syntyvä tieto on vapaasti saatavilla, ja sitä voidaan tulkita ja hyödyntää erilaisiin tarpeisiin, tietojärjestelmän avulla voidaan vauhdittaa kehitystä ja uuden tiedon löytämistä. Tiedon keskeisin tehtävä on kehittää ja parantaa organisaation osaamista, jolloin pitää olla tietoa siitä, mitä, miksi ja kuinka tietoa on käytetty organisaatiossa. Kaiken liiketoimintaprosesseissa tuotetun tiedon kohdalla pitäisi miettiä kolmea tiedonhallinnan osa-aluetta: tiedon luontia, hallintaa ja hyödyntämistä. Tavoitteena on saavuttaa yrityksen määrämuotoisen tietopääoman paras mahdollinen hallinta.Työssä kuvataan sitä, mitä sisällönhallinta on, sen eri tasoja, sen käsitteellistä sijoittumista tietämyksenhallintaan, sisällönhallinnan järjestelmiä ja niiden merkitystä liiketoimintaprosesseissa. Lisäksi tarkastellaan niitä syitä, joiden vuoksi yritykset kiinnostuvat organisaatiossa olevan määrämuotoisen tiedon sisällönhallinnasta. Lopuksi analysoidaan, millaisia voivat olla liiketoiminnalliset, kilpailulliset tai rahalliset tavoitteet, joita asetetaan sisällönhallinnan tietojärjestelmäprojektille. Työn tueksi on haastateltu neljän suomalaisen suuryrityksen sisällönhallinnan tietojärjestelmäprojektin asiantuntijoita. Heidän kommenttejaan on analysoitu ja niiden perusteella on tehty johtopäätöksiä niistä syistä, joiden vuoksi yritykset yleensä sijoittavat resurssejaan sisällönhallintaan.

Description de l’évolution du profil socio-cognitif et clinique d’une cohorte d’adolescents diabétiques de type 1 ayant suivi un programme d’éducation thérapeutique

Thèse réalisée en cotutelle entre Aix-Marseille Université et l'Université de Montréal

Sustaining Success Week 4 Task: Student Generated Content

Description of student generated content which you can choose to submit

Review of A-level Chemistry content 2015

ITEM DESCRIPTION After producing reviews of A-level Chemistry content in 2007 and 2010, we have updated the document to reflect the changes which have been introduced for first teaching in September 2015. We will be working with our network of teachers locally to monitor the impacts of the changes on teaching and the student experience with a view to releasing an updated version in the summer of 2017. This will aim to provide insights for university staff regarding the experiences of incoming students who will have been in the first cohort to have studied the new specifications. We are grateful to the Royal Society of Chemistry for support for the final stages of compiling this report. If you spot any errors or omissions, please don't hesitate to contact us.

Cetobacterium somerae sp nov from human feces and emended description of the genus Cetobacterium

Phenotypic and phylogenetic studies were performed on four isolates of an unidentified gram-negative, microaerotolerant, non-spore-forming, rod-shaped bacterium isolated from the feces of children. The unknown organism was bile resistant and produced acetic acid as the major end product of metabolism of peptides and carbohydrates. It possessed a low DNA G + C content of 31 mol %. Comparative 16S rRNA gene sequencing demonstrated that the four isolates were phylogenetically identical (100% 16S rRNA sequence similarity) and represent a hitherto unknown sub-line within the genus Cetobacterium. The novel bacterium displayed approximately 5% sequence divergence with Cetobacterium ceti, and can be readily distinguished from the latter by physiological and biochemical criteria. Based on phylogenetic and phenotypic evidence, it is proposed that the unknown fecal bacterium be classified in the genus Cetobacterium, as Cetobacterium somerae sp. nov. The proposed type strain of Cetobacterium somerae is WAL 14325(T) (ATCC BAA-474(T) = CCUG 46254T).

Phenotypic and phylogenetic characterization of a new Corynebacterium species from dogs: description of Corynebacterium auriscanis sp. nov.

Six strains of a previously undescribed catalase-positive coryneform bacterium isolated from clinical specimens from dogs were characterized by phenotypic and molecular genetic methods. Biochemical and chemotaxonomic studies revealed that the unknown bacterium belonged to the genus Corynebacterium sensu stricto. Comparative 16S rRNA gene sequencing showed that the six strains were genealogically highly related and constitute a new subline within the genus Corynebacterium; this subline is close to but distinct from C. falsenii, C. jeikeium, and C. urealyticum. The unknown bacterium from dogs was distinguished from all currently validated Corynebacterium species by phenotypic tests including electrophoretic analysis of whole-cell proteins. On the basis of phylogenetic and phenotypic evidence, it is proposed that the unknown bacterium be classified as a new species, Corynebacterium auriscanis. The type strain of C. auriscanis is CCUG 39938T.

Characterization of Actinomyces isolates from samples from the human urogenital tract: description of Actinomyces urogenitalis sp. nov.

Three strains of a previously undescribed Actinomyces-like bacterium were isolated from human clinical sources (urine, urethra and vaginal secretion). Biochemical testing and PAGE analysis of whole-cell proteins indicated that the strains were phenotypically homogeneous and distinct from previously described Actinomyces and Arcanobacterium species. Comparative 16S rRNA gene sequencing studies showed the bacterium to be a hitherto unknown subline within a group of Actinomyces species which includes Actinomyces bovis, the type species of the genus. Based on phylogenetic and phenotypic evidence it is proposed that the unknown bacterium from humans be classified as Actinomyces urogenitalis sp. nov. The type strain of Actinomyces urogenitalis is CCUG 38702T (= CIP 106421T).

Morpho-histochemical characterization of salivary gland cells of males of the tick Rhipicephalus sanguineus (Acari: Ixodidae) at different feeding stages: description of new cell types

This study describes the changes undergone by cells of the salivary glands of unfed and feeding (at day two and four post-attachment) Rhipicephalus sanguineus males, as well as new cell types. In unfed males, types I and II acini are observed with cells undifferentiated, undefined 1 and 2 (the latter, with atypical granules), a, c1 and c3; type III is composed of cells d and e; and type IV present cells g. In males at day two post-attachment, type I acini exhibit the same morphology of unfed individuals. An increase in size is observed in types II, III, and IV, as cells are filled with secretion granules. Some granules are still undergoing maturation. In type II acinus, cells a, b and c1-c8 are observed. Cells c7 and c8 are described for the first time. Cells c7 are termed as such due to the addition of polysaccharides in the composition of the secretion granules (in unfed individuals, they are termed undefined 1). Type III acini exhibit cells d and e completely filled with granules, and in type IV, cells g contain granules in several stages of maturation. In males at day four post-attachment, type I acini do not exhibit changes. Granular acini exhibit cells with fewer secretion granules, which are already mature. In type II acini, cells a, b, c1-c5 are present, type III exhibit cells d and e, and type IV contain cells g with little or no secretion. This study shows that in the salivary glands of R. sanguineus males, cells a, c1, and c3 of type II acinus, and cells d and e of type III do not exhibit changes in granular content, remaining continuously active during the entire feeding period. This indicates that during the intervals among feeding stages, gland cells reacquire the same characteristics found in unfed individuals, suggesting that they undergo reprogramming to be active in the next cycle.

Description of diet of pelagic fish in the southwestern Atlantic, Brazil

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Description of a ZZ/ZW sex chromosome system in Thoracocharax cf. stellatus (Teleostei, Characiformes, Gasteropelecidae)

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)