Working alliance in communication skills training for oncology clinicians: A controlled trial.

OBJECTIVE: The aim of this study was to evaluate the impact of communication skills training (CST) on working alliance and to identify specific communicational elements related to working alliance. METHODS: Pre- and post-training simulated patient interviews (6-month interval) of oncology physicians and nurses (N=56) who benefited from CST were compared to two simulated patient interviews with a 6-month interval of oncology physicians and nurses (N=57) who did not benefit from CST. The patient-clinician interaction was analyzed by means of the Roter Interaction Analysis System (RIAS). Alliance was measured by the Working Alliance Inventory - Short Revised Form. RESULTS: While working alliance did not improve with CST, generalized linear mixed effect models demonstrated that the quality of verbal communication was related to alliance. Positive talk and psychosocial counseling fostered alliance whereas negative talk, biomedical information and patient's questions diminished alliance. CONCLUSION: Patient-clinician alliance is related to specific verbal communication behaviors. PRACTICE IMPLICATIONS: Working alliance is a key element of patient-physician communication which deserves further investigation as a new marker and efficacy criterion of CST outcome.

Working memory load improves early stages of independent visual processing.

Increasing evidence suggests that working memory and perceptual processes are dynamically interrelated due to modulating activity in overlapping brain networks. However, the direct influence of working memory on the spatio-temporal brain dynamics of behaviorally relevant intervening information remains unclear. To investigate this issue, subjects performed a visual proximity grid perception task under three different visual-spatial working memory (VSWM) load conditions. VSWM load was manipulated by asking subjects to memorize the spatial locations of 6 or 3 disks. The grid was always presented between the encoding and recognition of the disk pattern. As a baseline condition, grid stimuli were presented without a VSWM context. VSWM load altered both perceptual performance and neural networks active during intervening grid encoding. Participants performed faster and more accurately on a challenging perceptual task under high VSWM load as compared to the low load and the baseline condition. Visual evoked potential (VEP) analyses identified changes in the configuration of the underlying sources in one particular period occurring 160-190 ms post-stimulus onset. Source analyses further showed an occipito-parietal down-regulation concurrent to the increased involvement of temporal and frontal resources in the high VSWM context. Together, these data suggest that cognitive control mechanisms supporting working memory may selectively enhance concurrent visual processing related to an independent goal. More broadly, our findings are in line with theoretical models implicating the engagement of frontal regions in synchronizing and optimizing mnemonic and perceptual resources towards multiple goals.

Product Platform Development from the Product Lines' Perspective: Case of Switching Platform

In the era of fast product development and customized product requirements, the concept of product platform has proven its power in practice. The product platform approach has enabledcompanies to increase the speed of product introductions while simultaneously benefit from efficiency and effectiveness in the development and production activities. The product platforms are technological bases, which can be used to develop several derivative products, and hence, the differentiation can be pushed closer to the product introduction. The product platform development has some specific features, which differ somewhat from the product development of single products. The time horizon is longer, since the product platform¿slife cycle is longer than individual product's. The long time-horizon also proposes higher market risks and the use of new technologies increases the technological risks involved. The end-customer interface might be far away, but there is not a lack of needs aimed at the product platforms ¿ in fact, the product platform development is very much balancing between the varying needs set to it by thederivative products. This dissertation concentrated on product platform development from the internal product lines' perspective of a singlecase. Altogether six product platform development factors were identified: 'Strategic and business fit of product platform', 'Project communication and deliverables', 'Cooperation with product platform development', 'Innovativeness of product platform architecture and features', 'Reliability and quality of product platform', and 'Promised schedules and final product platform meeting the needs'. From the six factors, three were found to influence quite strongly the overall satisfaction, namely 'Strategic and business fit of product platform', 'Reliability and quality of product platform', and 'Promised schedules and final product platform meeting the needs'. Hence, these three factors might be the ones a new product platform development unit should concentrate first in order to satisfy their closest customers, the product lines. The 'Project communication and deliverables' and 'Innovativeness of product platform architecture and features' were weaker contributors to the overall satisfaction. Overall, the factors explained quite well the satisfaction of the product lines with product platform development. Along the research, several interesting aspects about the very basic nature of the product platform development were found. The long time horizon of the product platform development caused challenges in the area of strategic fIT - a conflict between the short-term requirements and long term needs. The fact that a product platform was used as basis of several derivative products resulted into varying needs, and hence the match with the needs and the strategies. The opinions, that the releases of the larger product lines were given higher priorities, give an interesting contribution to the strategy theory of powerand politics. The varying needs of the product lines, the strengths of them as well as large number of concurrent releases set requirements to prioritization. Hence, the research showed the complicated nature of the product platform development in the case unIT - the very basic nature of the product platform development might be its strength (gaining efficiency and effectiveness in product development and product launches) but also the biggest challenge (developing products to meet several needs). As a single case study, the results of this research are not directly generalizable to all the product platform development activities. Instead, the research serves best as a starting point for additional research as well as gives some insights about the factors and challengesof one product development unit.

Building a usable and accessible semantic web interaction platform

Semantic Web applications take off is being slower than expected, at least with respect to “real-world” applications and users. One of the main reasons for this lack of adoption is that most Semantic Web user interfaces are still immature from the usability and accessibility points of view. This is due to the novelty of these technologies, but this also motivates the exploration of alternative interaction paradigms, different from the “traditional” Web or Desktop applications ones. Our proposal is realized in the Rhizomer platform, which explores the possibilities of the object–action interaction paradigm at the Web scale. This paradigm is well suited for heterogeneous resource spaces such as those common in the Semantic Web. Resources, described by metadata, correspond to the objects in the paradigm. Semantic web services, which are dynamically associated to these objects, correspond to the actions. The platform is being put into practice in the context of a research project in order to build an open application for media distribution based on Semantic Web technologies. Moreover, its usability and accessibility have been evaluated in this real setting and compared to similar systems.

Indications for cardiovascular magnetic resonance in children with congenital and acquired heart disease: an expert consensus paper of the Imaging Working Group of the AEPC and the Cardiovascular Magnetic Resonance Section of the EACVI.

This article provides expert opinion on the use of cardiovascular magnetic resonance (CMR) in young patients with congenital heart disease (CHD) and in specific clinical situations. As peculiar challenges apply to imaging children, paediatric aspects are repeatedly discussed. The first section of the paper addresses settings and techniques, including the basic sequences used in paediatric CMR, safety, and sedation. In the second section, the indication, application, and clinical relevance of CMR in the most frequent CHD are discussed in detail. In the current era of multimodality imaging, the strengths of CMR are compared with other imaging modalities. At the end of each chapter, a brief summary with expert consensus key points is provided. The recommendations provided are strongly clinically oriented. The paper addresses not only imagers performing CMR, but also clinical cardiologists who want to know which information can be obtained by CMR and how to integrate it in clinical decision-making.

WiBed, a platform for commodity wireless testbeds

This paper presents WiBed, a FOSS platform for WiFi testbeds based on OpenWRT Linux made to run on commodity IEEE802.11 WiFi routers part of the Community-lab.net project, a global testbed for Community networks. WiBed has been designed to support realistic low layer network experiments (according to the OSI model). This work recolects the details of the architecture, design and implementation of WiBed consolidated during its operation as a testbed.

Messaging Application Engine for Symbian Platform

Tämä diplomityö kuvaa viestintä sovelluksen ytimen kehitystyön Symbian-alustalle. Koko sovelluksen vaatimuksena oli vastaamattomiin puheluihin vastaaminen ennalta määritellyillä tekstiviesteillä käyttäjän määrittelemien sääntöjen mukaisesti. Ei-toiminnallisia vaatimuksia olivat resurssien käytön vähentäminen ja uudelleenkäytön mahdollistaminen. Täten tämän työn tavoitteena oli kehittää ydin, joka kapseloi sovelluksen sellaisen toiminnallisuuden, joka on käyttöliittymästä riippumatonta ja uudelleenkäytettävää. Kehitystyössä ohjasi Unified Process, joka on iteroiva, käyttötapauksien ohjaama ja arkkitehtuurikeskeinen ohjelmistoprosessi. Se kannusti käyttämään myös muita teollisuudenalan vakiintuneita menetelmiä, kuten suunnittelumalleja ja visuaalista mallintamista käyttäen Unified Modelling Languagea. Suunnittelumalleja käytettiin kehitystyön aikana ja ohjelmisto mallinnettiin visuaalisesti suunnittelun edistämiseksi ja selkiyttämiseksi. Alustan palveluita käytettiin hyväksi kehitysajan ja resurssien käytön minimoimiseksi. Ytimen päätehtäviksi määrättiin viestien lähettäminen sekä sääntöjen talletus ja tarkistaminen. Sovelluksen eri alueet, eli sovelluspalvelin ja käyttöliittymää, pystyivät käyttämään ydintä ja sillä ei ollut riippuvuuksia käyttöliittymätasolle. Täten resurssien käyttö väheni ja uudelleenkäytettävyys lisääntyi. Viestien lähettäminen toteutettiin Symbian-alustan menetelmin. Sääntöjen tallettamiseen tehtiin tallennuskehys, joka eristää sääntöjen sisäisen ja ulkoisen muodon. Tässä tapauksessa ulkoiseksi tallennustavaksi valittiin relaatiotietokanta. Sääntöjen tarkastaminen toteutettiin tavanomaisella olioiden yhteistoiminnalla. Päätavoite saavutettiin. tämä ja muut hyviksi arvioidut lopputulokset, kuten uudelleenkäytettävyys ja vähentynyt resurssien käyttö, arveltiin juontuvan suunnittelumallien ja Unified Processin käytöstä. Kyseiset menetelmät osoittivat mukautuvansa pieniinkin projekteihin. Menetelmien todettiin myös tukevan ja kannustavan kehitystyön aikaista oppimista, mikä oli välttämätöntä tässä tapauksessa.

The design and implementation of a standards-based mobile messaging platform - case WAP Push Proxy Gateway

Tässä diplomityössä perehdytään WAP:in Push -viitekehykseen. WAP-standardit määrittelevät kuinka Internet-tyyppisiä palveluita, joita voidaan käyttää erilaisia mobiileja päätelaiteitteita käyttäen, toteutetaan tehokkaalla ja verkkoteknologiasta riippumattomalla tavalla. WAP pohjautuu Internet:iin, mutta huomioi pienten päätelaitteiden ja mobiiliverkkojen rajoitukset ja erikoisominaisuudet. WAP Push viitekehys määrittelee verkon aloittaman palvelusisällön toimittamisen. Työn teoriaosassa käydään läpi yleinen WAP-arkkitehtuuri ja WAP-protokollapino käyttäen vertailukohtina lanka-Internetin arkkitehtuuria ja protokollapinoa. Edellistä perustana käyttäen tutustaan WAP Push -viitekehykseen. Käytännönosassa kuvataan WAP Push -välityspalvelimen suunnittelu ja kehitystyö. WAP Push -välityspalvelin on keskeinen verkkoelementti WAP Push -viitekehyksessä. WAP Push -välityspalvelin yhdistää Internetin ja mobiiliverkon tavalla, joka piilottaa teknologiaeroavaisuudet Internetissä olevalta palveluntuottajalta.

Designing a modular, open and expandable Bluetooth-platform

Lähitulevaisuudessa langattomien järjestelmien kaupalliset mahdollisuudet tulevat olemaan valtavia. Tutkiaksemme tulevia tarpeita, tässä diplomityössä esitellään kuinka voidaan suunnitella ja toteuttaa avoin langaton asiakas-palvelin järjestelmä. Järjestelmänä päätettiin käyttää Bluetooth:ia. Tutkituista langattomista standardeista Bluetooth sopii parhaiten akkukäyttöiselle laitteelle, jonka tulee olla monipuolinen. Lisäksi Bluetooth:iin on liitetty suuria kaupallisia odotuksia ja yksi työn tavoitteista olikin tutkia, ovatko nämä odotukset realistisia. Bluetooth:iin havaittiin liittyvän paljon ylimainontaa ja, sen todettiin olevan monimutkainen. Sillä on kuitenkin paljon ominaisuuksia ja erilaisten käyttöprofiilien avulla sitä voidaan käyttää monenlaisiin tehtäviin. Suunniteltu järjestelmä ajaa socket-palvelinta Bluetooth-yhteyden päällä. Tietyntyyppiseen liikenteeseen erikoistuneet socket:t tarjoavat vaaditun laajennattavuuden. Palvelin toteutetiin Linux-säikeenä ja se hallitsee Bluetooth protokollapinoa sekä sovelluksia, joita suoritetaan palvelimella. Näiden sovelluksien palvelut ovat muiden käytössä Bluetooth:n kautta.

Integrating Socket Server to the Workstation Environment of Series 40 Platform

Shortening development times of mobile phones are also accelerating the development times of mobile phone software. New features and software components should be partially implemented and tested before the actual hardware is ready. This brings challenges to software development and testing environments, especially on the user interface side. New features should be able to be tested in an environment, which has a look and feel like a real phone. Simulation environments are used to model real mobile phones. This makes possible to execute software in a mobile phone that does not yet exist. The purpose of this thesis is to integrate Socket Server software component to Series 40 simulation environments on Linux and Windows platforms. Socket Server provides TCP/IP connectivity for applications. All other software and hardware components below Socket Server do not exist in simulation environments. The scope of this work is to clarify how that can be done without connectivity problems, including design, implementation and testing phases.

Platform Architectures for Policy-Based Network Access Control

Tämä diplomityö käsittelee sääntöpohjaisen verkkoon pääsyn hallinnan (NAC) ratkaisuja arkkitehtonisesta näkökulmasta. Työssä käydään läpi Trusted Computing Groupin, Microsoft Corporationin, Juniper Networksin sekä Cisco Systemsin NAC-ratkaisuja. NAC koostuu joukosta uusia sekä jo olemassa olevia teknologioita, jotka auttavat ennalta määriteltyyn sääntökantaan perustuen hallitsemaan suojattuun verkkoon pyrkivien laitteiden tietoliikenneyhteyksiä. Käyttäjän tunnistamisen lisäksi NAC pystyy rajoittamaan verkkoon pääsyä laitekohtaisten ominaisuuksien perusteella, esimerkiksi virustunnisteisiin ja käyttöjärjestelmäpäivityksiin liittyen ja paikkaamaan tietyin rajoituksin näissä esiintyviä puutteita verkkoon pääsyn sallimiseksi. NAC on verraten uusi käsite, jolta puuttuu tarkka määritelmä. Tästä johtuen nykymarkkinoilla myydään ominaisuuksiltaan puutteellisia tuotteita NAC-nimikkeellä. Standardointi eri valmistajien NAC-komponenttien yhteentoimivuuden takaamiseksi on meneillään, minkä perusteella ratkaisut voidaan jakaa joko avoimia standardeja tai valmistajakohtaisia standardeja noudattaviksi. Esitellyt NAC-ratkaisut noudattavat standardeja joko rajoitetusti tai eivät lainkaan. Mikään läpikäydyistä ratkaisuista ei ole täydellinen NAC, mutta Juniper Networksin ratkaisu nousee niistä potentiaalisimmaksi jatkokehityksen ja -tutkimuksen kohteeksi TietoEnator Processing & Networks Oy:lle. Eräs keskeinen ongelma NAC-konseptissa on työaseman tietoverkolle toimittama mahdollisesti valheellinen tietoturvatarkistuksen tulos, minkä perusteella pääsyä osittain hallitaan. Muun muassa tähän ongelmaan ratkaisuna voisi olla jo nykytietokoneista löytyvä TPM-siru, mikä takaa tiedon oikeellisuuden ja koskemattomuuden.

Metabolic connectivity as index of verbal working memory.

Positron emission tomography (PET) data are commonly analyzed in terms of regional intensity, while covariant information is not taken into account. Here, we searched for network correlates of healthy cognitive function in resting state PET data. PET with [(18)F]-fluorodeoxyglucose and a test of verbal working memory (WM) were administered to 35 young healthy adults. Metabolic connectivity was modeled at a group level using sparse inverse covariance estimation. Among 13 WM-relevant Brodmann areas (BAs), 6 appeared to be robustly connected. Connectivity within this network was significantly stronger in subjects with above-median WM performance. In respect to regional intensity, i.e., metabolism, no difference between groups was found. The results encourage examination of covariant patterns in FDG-PET data from non-neurodegenerative populations.

Indications for cardiovascular magnetic resonance in children with congenital and acquired heart disease: an expert consensus paper of the Imaging Working Group of the AEPC and the Cardiovascular Magnetic Resonance Section of the EACVI.

This article provides expert opinion on the use of cardiovascular magnetic resonance (CMR) in young patients with congenital heart disease (CHD) and in specific clinical situations. As peculiar challenges apply to imaging children, paediatric aspects are repeatedly discussed. The first section of the paper addresses settings and techniques, including the basic sequences used in paediatric CMR, safety, and sedation. In the second section, the indication, application, and clinical relevance of CMR in the most frequent CHD are discussed in detail. In the current era of multimodality imaging, the strengths of CMR are compared with other imaging modalities. At the end of each chapter, a brief summary with expert consensus key points is provided. The recommendations provided are strongly clinically oriented. The paper addresses not only imagers performing CMR, but also clinical cardiologists who want to know which information can be obtained by CMR and how to integrate it in clinical decision-making.