Communication with terminal cancer patients in palliative care: are there differences between nurses and physicians?

The aim of this study was to find whether there were interprofessional differences in specific elements of communication with terminal cancer patients and decision-making processes that concern such patients. Given that interdisciplinary team work is one of the basic values in palliative care, if there are conflicting views between professions on such important issues it is most important to know about these and to understand them. A questionnaire utilized in an earlier survey of palliative care physicians and addressing their attitudes to and beliefs about specific elements of communication and decision making was sent to a sample of palliative care nurses working in the same regions, i.e. the French-speaking parts of Switzerland, Belgium and France. After a second mailing (reminder), 135 of the 163 questionnaires (83%) were returned. There was general agreement between nurses and physicians on questions dealing with perceptions of patients' knowledge of their diagnosis and stage of disease, patients' need for information, "do not resuscitate" orders and ethical principles in decision-making processes. Statistically significant, but small, differences between professional groups were only observed for a minority of the questions. Interprofessional differences in specific elements of communication with terminal cancer patients and decision-making processes affecting these patients were not so marked that they could be called "conflicting interprofessional views."

Variability of the radius growth at 25 years old Pinus uncinata Miller ex Mirbel in the North-East Spanish Pyrenees

It has been studied the variability of stem radial growth in four radius orientations at the age of 25 years old trees. The species was Pinus uncinata. The sampling sites, located in the North East Spanish Pyrenees belong to different plant communities. An ANOVA analysis was performed in order to find out which factors, the radio orientation, plant community of the site and tree itself are significative or have some kind of influence on the tree radial growth.

Iowa Immunization Program Annual Report 2010, March 31, 2011

The Bureau of Immunization is part of the Division of Acute Disease Prevention and Emergency Response (ADPER) at the Iowa Department of Public Health (IDPH). The ADPER division provides support, technical assistance and consultation to local hospitals, public health agencies, community health centers, emergency medical service programs and local health care providers regarding infectious diseases, disease prevention and control, injury prevention and public health and health care emergency preparedness and response. The division encompasses the Center for Acute Disease Epidemiology (CADE), the Bureau of Immunization and Tuberculosis (ITB), the Bureau of Emergency Medical Services (EMS), the Bureau of Communication and Planning (CAP), the Office of Health Information Technology (HIT), and the Center for Disaster Operations and Response (CDOR). The Bureau of Immunization and Tuberculosis includes the Immunization Program, the Tuberculosis Control Program, and the Refugee Health Program. The mission of the Immunization Program is to decrease vaccine‐preventable diseases through education, advocacy and partnership. While there has been major advancement in expanding immunizations to many parts of Iowa’s population, work must continue with public and private health care providers to promote the program’s vision of healthy Iowans living in communities free of vaccine‐preventable diseases. Accomplishing this goal will require achieving and maintaining high vaccination coverage levels, improving vaccination strategies among under‐vaccinated populations, prompt reporting and thorough investigation of suspected disease cases, and rapid institution of control measures. The Immunization Program is comprised of multiple programs that provide immunization services throughout the state: Adolescent Immunization Program, Adult Immunization Program, Immunization Registry Information System (IRIS), Vaccines for Children Program (VFC), Perinatal Hepatitis B Program, and Immunization Assessment Program.

Iowa Immunization Program Annual Report 2011, February 20, 2012

The Bureau of Immunization is part of the Division of Acute Disease Prevention and Emergency Response (ADPER) at the Iowa Department of Public Health (IDPH). The ADPER division provides support, technical assistance and consultation to local hospitals, public health agencies, community health centers, emergency medical service programs and local health care providers regarding infectious diseases, disease prevention and control, injury prevention and public health and health care emergency preparedness and response. The division encompasses the Center for Acute Disease Epidemiology (CADE), the Bureau of Immunization and Tuberculosis (ITB), the Bureau of Emergency Medical Services (EMS), the Bureau of Communication and Planning (CAP), the Office of Health Information Technology (HIT), and the Center for Disaster Operations and Response (CDOR). The Bureau of Immunization and Tuberculosis includes the Immunization Program, the Tuberculosis Control Program, and the Refugee Health Program. The mission of the Immunization Program is to decrease vaccine‐preventable diseases through education, advocacy and partnership. While there has been major advancement in expanding immunizations to many parts of Iowa’s population, work must continue with public and private health care providers to promote the program’s vision of healthy Iowans living in communities free of vaccine‐preventable diseases. Accomplishing this goal will require achieving and maintaining high vaccination coverage levels, improving vaccination strategies among under‐vaccinated populations, prompt reporting and thorough investigation of suspected disease cases, and rapid institution of control measures. The Immunization Program is comprised of multiple programs that provide immunization services throughout the state: Adolescent Immunization Program, Adult Immunization Program, Immunization Registry Information System (IRIS), Vaccines for Children Program (VFC), Perinatal Hepatitis B Program, and Immunization Assessment Program.

Iowa Immunization Program Annual Report 2012, February 20, 2012

The Bureau of Immunization is part of the Division of Acute Disease Prevention and Emergency Response (ADPER) at the Iowa Department of Public Health (IDPH). The ADPER division provides support, technical assistance and consultation to local hospitals, public health agencies, community health centers, emergency medical service programs and local health care providers regarding infectious diseases, disease prevention and control, injury prevention and public health and health care emergency preparedness and response. The division encompasses the Center for Acute Disease Epidemiology (CADE), the Bureau of Immunization and Tuberculosis (ITB), the Bureau of Emergency Medical Services (EMS), the Bureau of Communication and Planning (CAP), the Office of Health Information Technology (HIT), and the Center for Disaster Operations and Response (CDOR). The Bureau of Immunization and Tuberculosis includes the Immunization Program, the Tuberculosis Control Program, and the Refugee Health Program. The mission of the Immunization Program is to decrease vaccine‐preventable diseases through education, advocacy and partnership. While there has been major advancement in expanding immunizations to many parts of Iowa’s population, work must continue with public and private health care providers to promote the program’s vision of healthy Iowans living in communities free of vaccine‐preventable diseases. Accomplishing this goal will require achieving and maintaining high vaccination coverage levels, improving vaccination strategies among under‐vaccinated populations, prompt reporting and thorough investigation of suspected disease cases, and rapid institution of control measures. The Immunization Program is comprised of multiple programs that provide immunization services throughout the state: Adolescent Immunization Program, Adult Immunization Program, Immunization Registry Information System (IRIS), Vaccines for Children Program (VFC), Perinatal Hepatitis B Program, and Immunization Assessment Program.

2014 Immunizations in Iowa, Iowa Immunization Program Annual Report, January 11, 2016

The Bureau of Immunization is part of the Division of Acute Disease Prevention and Emergency Response (ADPER) at the Iowa Department of Public Health (IDPH). The ADPER division provides support, technical assistance and consultation to local hospitals, public health agencies, community health centers, emergency medical service programs and local health care providers regarding infectious diseases, disease prevention and control, injury prevention and public health and health care emergency preparedness and response. The division encompasses the Center for Acute Disease Epidemiology (CADE), the Bureau of Immunization and Tuberculosis (ITB), the Bureau of Emergency Medical Services (EMS), the Bureau of Communication and Planning (CAP), the Office of Health Information Technology (HIT), and the Center for Disaster Operations and Response (CDOR). The Bureau of Immunization and Tuberculosis includes the Immunization Program, the Tuberculosis Control Program, and the Refugee Health Program. The mission of the Immunization Program is to decrease vaccine‐preventable diseases through education, advocacy and partnership. While there has been major advancement in expanding immunizations to many parts of Iowa’s population, work must continue with public and private health care providers to promote the program’s vision of healthy Iowans living in communities free of vaccine‐preventable diseases. Accomplishing this goal will require achieving and maintaining high vaccination coverage levels, improving vaccination strategies among under‐vaccinated populations, prompt reporting and thorough investigation of suspected disease cases, and rapid institution of control measures. The Immunization Program is comprised of multiple programs that provide immunization services throughout the state: Adolescent Immunization Program, Adult Immunization Program, Immunization Registry Information System (IRIS), Vaccines for Children Program (VFC), Perinatal Hepatitis B Program, and Immunization Assessment Program.

Why do they separate it or not? Attitudes and behaviors towards organic waste separation

This article shows the results of an exploratory study related to the separation of organic waste in order to offer suggestions for the improvement of waste disposal communication campaigns. The overall objective is to analyze attitude and behavior of those who do and those who do not separate organic waste, related to a specific promotional campaign carried out in two neighborhoods, in the municipality of Badalona (Spain), within the framework of the study of proenvironmental attitudes and behaviors and based on the Psychosocial Four Spheres Model. 1,010 interviews were conducted and data was analyzed using Chi-Squared Automatic Interaction Detector (CHAID). Waste separation behavior was used as a dependent variable. The reasons given to explain why people do or do not separate organic waste and sociodemographic variables, have been introduced as independent variables. In accordance with the Four Spheres Model, results show significant differences in waste separation. Based on the profiles obtained, we find some predictive variables that facilitate the development of communication campaigns according to the requirements of each community.

Why do they separate it or not? Attitudes and behaviors towards organic waste separation

This article shows the results of an exploratory study related to the separation of organic waste in order to offer suggestions for the improvement of waste disposal communication campaigns. The overall objective is to analyze attitude and behavior of those who do and those who do not separate organic waste, related to a specific promotional campaign carried out in two neighborhoods, in the municipality of Badalona (Spain), within the framework of the study of proenvironmental attitudes and behaviors and based on the Psychosocial Four Spheres Model. 1,010 interviews were conducted and data was analyzed using Chi-Squared Automatic Interaction Detector (CHAID). Waste separation behavior was used as a dependent variable. The reasons given to explain why people do or do not separate organic waste and sociodemographic variables, have been introduced as independent variables. In accordance with the Four Spheres Model, results show significant differences in waste separation. Based on the profiles obtained, we find some predictive variables that facilitate the development of communication campaigns according to the requirements of each community.

Extending Learning Objects by Means of Social Networking

Learning objects have been the promise of providing people with high quality learning resources. Initiatives such as MIT Open-CourseWare, MERLOT and others have shown the real possibilities of creating and sharing knowledge through Internet. Thousands of educational resources are available through learning object repositories. We indeed live in an age of content abundance, and content can be considered as infrastructure for building adaptive and personalized learning paths, promoting both formal and informal learning. Nevertheless, although most educational institutions are adopting a more open approach, publishing huge amounts of educational resources, the reality is that these resources are barely used in other educational contexts. This paradox can be partly explained by the dificulties in adapting such resources with respect to language, e-learning standards and specifications and, finally, granularity. Furthermore, if we want our learners to use and take advantage of learning object repositories, we need to provide them with additional services than just browsing and searching for resources. Social networks can be a first step towards creating an open social community of learning around a topic or a subject. In this paper we discuss and analyze the process of using a learning object repository and building a social network on the top of it, with respect to the information architecture needed to capture and store the interaction between learners and resources in form of learning object metadata.

Exploring the use of mobile communications in a retirement home in Toronto: Preliminary results

This paper describes preliminary results of a qualitative case study on mobile communication conducted in an elders¿ retirement home in Toronto (Ontario, Canada) in May 2012. This is part of an international research project on the relationship between mobile communications and older people.Secondary data at a Canadian level contextualizes the case study. We focus ondemographic characteristics and on adoption and use of information and communication technologies (ICTs) broken by age.Participants in the study (21 individuals) are between 75 and 98 years of age, thereforewe can consider that the gathered evidence refers to the ¿old¿ older. Mobile phoneusers in the sample describe very specific uses of the mobile phone, while non-usersreport not facing external pressures for adopting that technology. The main channel formediated communication is the landline; in consequences mobile phones ¿when used¿ constitute an extra layer of communication. Finally, when members of the personal network of the individuals live abroad they are more prone to use Internet and Skype. We are also able to find ex-users of both mobile telephony and computers/internet who stopped using these technologies because they did not find any use for them.

Exploring the use of mobile communications in a sample of older people: Preliminary results of a case study in Los Angeles

This paper introduces a qualitative case study on mobile communication among the older population (60+ years old) conducted in Great Los Angeles (CA, USA) in autumn 2011. Methodology, fieldwork and preliminary results are discussed.Before, country-level data is presented to better understand the specific characteristics of the studied individuals. The section focus is on demographics and on acceptance and use of information and communication technologies (ICT).Preliminary results show that within the sample under study (20 individuals) there is a high number of mobile phone users (15) while among non-mobile users (5), three of them decide to stop using this technology. A majority of mobile phone adopters describe a very limited use of the device for everyday life communications. Finally,while Internet is really popular within the sample (14 users), just 3 individuals go online through their mobile telephone.

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.

Studies on coordination of systems development process

This thesis examines coordination of systems development process in a contemporary software producing organization. The thesis consists of a series of empirical studies in which the actions, conceptions and artifacts of practitioners are analyzed using a theory-building case study research approach. The three phases of the thesis provide empirical observations on different aspects of systemsdevelopment. In the first phase is examined the role of architecture in coordination and cost estimation in multi-site environment. The second phase involves two studies on the evolving requirement understanding process and how to measure this process. The third phase summarizes the first two phases and concentrates on the role of methods and how practitioners work with them. All the phases provide evidence that current systems development method approaches are too naïve in looking at the complexity of the real world. In practice, development is influenced by opportunity and other contingent factors. The systems development processis not coordinated using phases and tasks defined in methods providing universal mechanism for managing this process like most of the method approaches assume.Instead, the studies suggest that managing systems development process happens through coordinating development activities using methods as tools. These studies contribute to the systems development methods by emphasizing the support of communication and collaboration between systems development participants. Methods should not describe the development activities and phases in a detail level, butshould include the higher level guidance for practitioners on how to act in different systems development environments.

Using Pareto optimality to explore the topology and dynamics of the human connectome.

Graph theory has provided a key mathematical framework to analyse the architecture of human brain networks. This architecture embodies an inherently complex relationship between connection topology, the spatial arrangement of network elements, and the resulting network cost and functional performance. An exploration of these interacting factors and driving forces may reveal salient network features that are critically important for shaping and constraining the brain's topological organization and its evolvability. Several studies have pointed to an economic balance between network cost and network efficiency with networks organized in an 'economical' small-world favouring high communication efficiency at a low wiring cost. In this study, we define and explore a network morphospace in order to characterize different aspects of communication efficiency in human brain networks. Using a multi-objective evolutionary approach that approximates a Pareto-optimal set within the morphospace, we investigate the capacity of anatomical brain networks to evolve towards topologies that exhibit optimal information processing features while preserving network cost. This approach allows us to investigate network topologies that emerge under specific selection pressures, thus providing some insight into the selectional forces that may have shaped the network architecture of existing human brains.

Real-time Quality of Service Controller for Differentiated Services

IP-verkkojen hyvin tunnettu haitta on, että nämä eivät pysty takaamaan tiettyä palvelunlaatua (Quality of Service) lähetetyille paketeille. Seuraavat kaksi tekniikkaa pidetään lupaavimpina palvelunlaadun tarjoamiselle: Differentiated Services (DiffServ) ja palvelunlaatureititys (QoS Routing). DiffServ on varsin uusi IETF:n määrittelemä Internetille tarkoitettu palvelunlaatumekanismi. DiffServ tarjoaa skaalattavaa palvelujen erilaistamista ilman viestintää joka hypyssä ja per-flow –tilan ohjausta. DiffServ on hyvä esimerkki hajautetusta verkkosuunnittelusta. Tämän palvelutasomekanismin tavoite on viestintäjärjestelmien suunnittelun yksinkertaistaminen. Verkkosolmu voidaan rakentaa pienestä hyvin määritellystä rakennuspalikoiden joukosta. Palvelunlaatureititys on reititysmekanismi, jolla liikennereittejä määritellään verkon käytettävissä olevien resurssien pohjalta. Tässä työssä selvitetään uusi palvelunlaatureititystapa, jota kutsutaan yksinkertaiseksi monitiereititykseksi (Simple Multipath Routing). Tämän työn tarkoitus on suunnitella palvelunlaatuohjain DiffServille. Tässä työssä ehdotettu palvelunlaatuohjain on pyrkimys yhdistää DiffServ ja palvelunlaatureititysmekanismeja. Työn kokeellinen osuus keskittyy erityisesti palvelunlaatureititysalgoritmeihin.