Teollisuustuotteen markkinointisuunnitelma. Case: Omni Weight Control Oy

Tutkielman tavoitteena on markkinointisuunnitelman laatiminen teollisuustuotteelle, jota business-to-business -markkinoilla toimiva case-yritys valmistaa. Aihetta tarkastellaan ensin teoreettisesti lähdekirjallisuuden avulla ja sen jälkeen empiirisesti case-yrityksen näkökulmasta. Tutkimusmenetelmänä on normatiivinen eli soveltava case-tutkimus. Tutkimusote on kvalitatiivinen. Markkinointisuunnitelma laaditaan analysoimalla yrityksen ulkoista ja sisäistä toimintaympäristöä, asettamalla markkinoinnin tavoitteet, määrittelemällä markkinointistrategiat ja yksilöimällä toimintaohjeet. Markkinointisuunnitelman laatiminen kannattaa, sillä se tehostaa yrityksen ulkoista markkinointia. Tutkielman tuloksena voidaan todeta, että case-yrityksellä on hyvät mahdollisuudet menestyä hihnavaakamarkkinoilla uudella tuotteellaan, kunhan se saa nimeään tunnetuksi.

Establishing the Stages and Processes of Change for Weight Loss by Consensus of Experts

The present study aimed to establish, by a consensus of experts, the stages and processes of change for weight management in overweight and obese people. The first step involved developing two questionnaires aimed at assessing stages and processes of change for weight loss in overweight and obese people. The processes-ofchange questionnaire consisted of 12 subscales, and contained 107 items. A three-round Delphi study was carried out through a website, where participants were asked to give their opinion about the representativeness and clarity of the scale items. The stages-of-change questionnaire consisted of five items and was presented in the final round of the study. A team of 66 experts in the obesity field from 29 countries participated in the study. They were selected either because they belonged to the organizing committee of international associations related to obesity, or because of their research career. The required changes in the questionnaire were made according to the opinions of the participants. Some of these were the result of the group statistical response, whereas others were due to the suggestions made by the participants. A final version of the questionnaire consisting of 63 items was eventually obtained. The present study produced two questionnaires to assess stages and processes of change for weight management. The strength of the study lies in the consensus reached by the panel of experts in order to establish the required content of the questionnaires. The two measures provide useful tools for practitioners who wish to tailor weight-management interventions according to transtheoretical model constructs.

Older persons' perceptions of general practitioner or specialist primary care physicians : same point of view? : older persons' primary care perception

La perception du patient vis-à-vis de son médecin traitant (MT) a suscité beaucoup de recherches et d'interet, notamment à cause de l'importance de la relation médecin-patient nécessaire à la qualité des soins. En Suisse, dans un contexte de libre choix du médecin, le rôle de MT peut être assumé par un generalise mais aussi, théoriquement, par un spécialiste. La fréquence de cette situation est cependant inconnue de même que son impact sur l'expérience des patients. L'objectif principal de cette etude était de décrire l'expérience des personnes âgées du canton de Vaud auprès de leur medecin traitant et de tester l'hypothèse selon laquelle cette expérience serait différente lorsque le MT est décrit comme « Généraliste » (MT Gén) ou comme « Spécialiste » (MT Spéc). Méthode : La recherche a été effectuée sur la base des données d'une enquête par questionnaire, envoyé à la population lausannoise participant à l'étude Lc65+ et à un échantillon supplémentaire de personnes agees de 68 ans ou plus sélectionnées aléatoirement dans le canton de Vaud. L'analyse a porté sur 17 items relatifs à la perception qu'ont les patients de leur MT, regroupés en 4 thèmes ? Access,bihte/Disponibilité, Relation Médecin-Patient, Information et Continuité des soins Nous ayons également analysé le recours déclaré aux soins ambulatoires, aux consultations de services d urgence, ainsi qu'aux actes de prévention. Les différences de perception et de recours selon le type de MT (Gen vs Spéc) ont été analysées par des modèles multivariés tenant compte de l'âge du sexe de I education, de la morbidité, de la présence de symptômes dépressifs et de la durée de la relation medecin-patient. Résultats : Les participants ont exprimé une perception favorable de leur MT à des taux excédant 75% pour la plupart des 17 items. Cependant, seulement 38 à 51% des participants ont répondu positivement aux questions relatives à la disponibilité en dehors des heures d'ouvertures, à l'accès au MT le soir ou en tin de semaine, à la possibilité de visites à domicile, à la probabilité de se voir prescrire des medicaments coûteux en cas de besoin, ou à la connaissance du médecin des médicaments en vente libre que le patient consomme. Les analyses bivariées et multivariées n'ont pas montré de différence entre les groupes MT Gén et MT Spec quant à la perception qu'ont les patients de leur MT, au recours aux actes de prévention ou aux services de santé. Conclusion : L'expérience des personnes interrogées était globalement positive, à part quelques questions concernant principalement le thème de l'Accessibilité/Disponibilité du MT. Nous n'avons pas mis en evidence de différence de perception ou de recours aux soins entre les deux groupes que nous avons analyses pour tester notre hypothèse. Perspective : Cette étude connaît des limites (données rapportées par les participants, groupe des MT Spéc de taille restreinte, absence de données sur les non-répondants, possible conflit de loyauté vis-à-vis du MT pour certaines questions) mais repose sur un large échantillon lui conférant une puissance suffisante, aléatoirement sélectionné dans une population géographiquement définie. Bien que ces résultats ne soient généralisables qu'au canton de Vaud, elle montre d'abord que les spécialistes reconnus comme MT s'inscrivent généralement dans des disciplines impliquant une formation en medec.ne interne. Dans cette circonstance, elle ne met en évidence aucune différence de résultats entre les personnes âgées traitées par un MT généraliste ou spécialiste.

A new formula for calculating standard liver volume for living donor liver transplantation without using body weight.

BACKGROUND & AIMS: The standard liver volume (SLV) is widely used in liver surgery, especially for living donor liver transplantation (LDLT). All the reported formulas for SLV use body surface area or body weight, which can be influenced strongly by the general condition of the patient. METHODS: We analyzed the liver volumes of 180 Japanese donor candidates and 160 Swiss patients with normal livers to develop a new formula. The dataset was randomly divided into two subsets, the test and validation sample, stratified by race. The new formula was validated using 50 LDLT recipients. RESULTS: Without using body weight-related variables, age, thoracic width measured using computed tomography, and race independently predicted the total liver volume (TLV). A new formula: 203.3-(3.61×age)+(58.7×thoracic width)-(463.7×race [1=Asian, 0=Caucasian]), most accurately predicted the TLV in the validation dataset as compared with any other formulas. The graft volume for LDLT was correlated with the postoperative prothrombin time, and the graft volume/SLV ratio calculated using the new formula was significantly better correlated with the postoperative prothrombin time than the graft volume/SLV ratio calculated using the other formulas or the graft volume/body weight ratio. CONCLUSIONS: The new formula derived using the age, thoracic width and race predicted both the TLV in the healthy patient group and the SLV in LDLT recipients more accurately than any other previously reported formulas.

Perceptions of Alzheimer's Disease in the French Population : Evolutions between 2008 and 2013 and Associated Factors in 2013

Abstract: Background. The negative image surrounding AD has a substantial impact on caregiving and on those affected by the disease. Opinion surveys was created as part of the 2008-2012 Alzheimer Plan in France, which included two surveys in general population, at the beginning and at the end. Objective. To evaluate changes of the French population in perceptions, knowledge and beliefs since 5 years and to analyze dimensions with sociodemographics criteria and proximity with AD. Methods. After selection by quota sampling, 2013 French people aged 18 years and over were interviewed by phone in 2008 and 2509 in 2013. Chi-squared tests were carried out to measure the changes between two periods and multivariate logistics regressions were used to assess perceptions. Results. People who cited AD as one of the three most serious diseases increased in 2013 (33.6% versus 26.7% in 2008; p < 0.001). There was no significant change as regards the fear, the sense of being informed and the feeling of embarrassment. Opinions "there are treatments available to improve the wellbeing of patients" and "it is normal to suffer memory loss as you get older" decreased in 2013. Close family carers had a greater sense of the seriousness, a higher risk perception, a better sense of being informed and a greater ease in the presence of a person with AD. Conclusions. The results serve as indicators of the effects of the Alzheimer Plan on French society and testify to the rather weak impact of the Plan on public opinion.

What Role Does Sleep Play in Weight Gain in the First Semester of University?

We hypothesized that shorter sleep durations and greater variability in sleep patterns are associated with weight gain in the first semester of university. Students (N = 132) completed daily sleep diaries for 9 weeks, completed the MEQ (chronotype) and CES-D (depressed mood) at week 9, and self-reported weight/height (weeks 1 & 9). Mean and variability scores were calculated for sleep duration (TST, TSTv), bedtime (BT, BTv), and wake time (WT, WTv). An initial hierarchical regression evaluated (block 1) sex, ethnicity; (block 2) depressed mood, chronotype; (block 3) TST; (block 4) BT, WT; and (block 5; R(2) change = 0.09, p = 0.005) TSTv, BTv, WTv with weight change. A sex-by-TSTv interaction was found. A final model showed that ethnicity, TST, TSTv, and BTv accounted for 31% of the variance in weight change for males; TSTv was the most significant contributor (R(2) change = 0.21, p < 0.001). Daily variability in sleep duration contributes to males' weight gain. Further investigation needs to examine sex-specific outcomes for sleep and weight.

PPARα is Required for PPARδ action in regulation of body weight and hepatic steatosis in mice.

NlmCategory="UNASSIGNED">Peroxisome proliferator activated receptors alpha (PPARα) and delta (PPARδ) belong to the nuclear receptor superfamily. PPARα is a target of well established lipid-lowering drugs. PPARδ (also known as PPARβ/δ) has been investigated as a promising antidiabetic drug target; however, the evidence in the literature on PPARδ effect on hepatic lipid metabolism is inconsistent. Mice conditionally expressing human PPARδ demonstrated pronounced weight loss and promoted hepatic steatosis when treated with GW501516 (PPARδ-agonist) when compared to wild type mice. This effect was completely absent in mice with either a dominant negative form of PPARδ or deletion of the DNA binding domain of PPARδ. This confirmed the absolute requirement for PPARδ in the physiological actions of GW501516 and confirmed the potential utility against the human form of this receptor. Surprisingly the genetic deletion of PPARα also abrogated the effect of GW501516 in terms of both weight loss and hepatic lipid accumulation. Also the levels of the PPARα endogenous agonist 16:0/18:1-GPC were shown to be modulated by PPARδ in wild type mice. Our results show that both PPARδ and PPARα receptors are essential for GW501516-driven adipose tissue reduction and subsequently hepatic steatosis, with PPARα working downstream of PPARδ.

Importance of early weight changes to predict long-term weight gain during psychotropic drug treatment.

BACKGROUND: Psychotropic drugs can induce substantial weight gain, particularly during the first 6 months of treatment. The authors aimed to determine the potential predictive power of an early weight gain after the introduction of weight gain-inducing psychotropic drugs on long-term weight gain. METHOD: Data were obtained from a 1-year longitudinal study ongoing since 2007 including 351 psychiatric (ICD-10) patients, with metabolic parameters monitored (baseline and/or 1, 3, 6, 9, 12 months) and with compliance ascertained. International Diabetes Federation and World Health Organization definitions were used to define metabolic syndrome and obesity, respectively. RESULTS: Prevalences of metabolic syndrome and obesity were 22% and 17%, respectively, at baseline and 32% and 24% after 1 year. Receiver operating characteristic analyses indicated that an early weight gain > 5% after a period of 1 month is the best predictor for important long-term weight gain (≥ 15% after 3 months: sensitivity, 67%; specificity, 88%; ≥ 20% after 12 months: sensitivity, 47%; specificity, 89%). This analysis identified most patients (97% for 3 months, 93% for 12 months) who had weight gain ≤ 5% after 1 month as continuing to have a moderate weight gain after 3 and 12 months. Its predictive power was confirmed by fitting a longitudinal multivariate model (difference between groups in 1 year of 6.4% weight increase as compared to baseline, P = .0001). CONCLUSION: Following prescription of weight gain-inducing psychotropic drugs, a 5% threshold for weight gain after 1 month should raise clinician concerns about weight-controlling strategies.

Utilisation de matériel biologique pour la recherche biomédicale en Suisse : contexte actuel, perceptions de la population générale, des patients et des professionnels de santé

[Table des matières] 1. Introduction (Problématique, Aperçu global) - 2. Méthode (Revue systématique de la littérature, Analyse du cadre réglementaire, Consultation des experts, Analyse des perceptions et attentes de la population générale, des patients et des professionnels de santé en matière d'utilisation du matériel biologique, Définition de l'outil pour la recherche quantitative en population générale) - 3. Revue de littérature (Tendance générale, Questions controversées, Perception de la population générale et des patients, Synthèse) - 4. Cadre légal et réglementaire relatif à la recherche sur l'être humain (Le cadre international, Le cadre fédéral, Le cadre du canton de Vaud, Synthèse) - 5. Consultation des experts (Etat des lieux de la pratique, Perception de la situation par les experts) - 6. Perceptions et attentes de la population générale, des patients et des professionnels de santé en matière d'utilisation de matériel biologique - 7. Définition de l'outil pour la recherche quantitative en population générale - 8. Poster : Conférence suisse de santé publique - 9. Bibliographie - 10. Annexes (Evolution de la recherche systématique de la littérature, Vignettes présentées aux participants des focus group, Synthèse des focus group, Recommandations de G. Helgesson pour l'utilisation des échantillons, Etudes populationnelles à l'étranger, Modèles de l'ASSM, Informations et consentements à la biobanque de Lausanne, Questionnaire)

Swiss family physicians' perceptions and attitudes towards knowledge translation practices.

BACKGROUND: Several studies have been performed to understand the way family physicians apply knowledge from medical research in practice. However, very little is known concerning family physicians in Switzerland. In an environment in which information constantly accumulates, it is crucial to identify the major sources of scientific information that are used by family physicians to keep their medical knowledge up to date and barriers to use these sources. Our main objective was to examine medical knowledge translation (KT) practices of Swiss family physicians. METHODS: The population consisted of French- and German-speaking private practice physicians specialised in family medicine. We conducted four interviews and three focus groups (n = 25). The interview guides of the semi-structured interviews and focus groups focused on (a) ways and means used by physicians to keep updated with information relevant to clinical practice; (b) how they consider their role in translating knowledge into practice; (c) potential barriers to KT; (d) solutions proposed by physicians for effective KT. RESULTS: Family physicians find themselves rather ambivalent about the translation of knowledge based on scientific literature, but generally express much interest in KT. They often feel overwhelmed by "information floods" and perceive clinical practice guidelines and other supports to be of limited usefulness for their practice. They often combine various formal and informal information sources to keep their knowledge up to date. Swiss family physicians report considering themselves as artisans, caring for patients with complex needs. CONCLUSION: Improved performance of KT initiatives in family medicine should be tailored to actual needs and based on high quality evidence-based sources.