Asentamientos rurales y estructuración de la Layetania interior (Barcelona): romanización e impacto de los programas de organización territorial

This paper presents the results of the first phase of archaeological and historical study developed in the Vallès Oriental. It has done a complete study of the archaeological information available from the several documentary sources (bibliography, IPAC, etc.). This has lead to an interpretative update on the forms of occupation and settlement dynamics developed in the study area during the 5th BC to 1st century AD. Preliminary results of the archaeomorphological analysis focused primarily on the road network are also presented. The first results highlight the importance of territorial organization programs of the late 2nd BC and 1st century BC. In this sense, it has been documented a close relationship between the road network and the distribution of rural settlements in late-Republican and Augustan periods. The use of databases in the management of archaeological information, and especially the application of GIS in the analysis and interpretation of data, suggest new interpretive approaches.

Mapping the human connectome at multiple scales with diffusion spectrum MRI.

The global structural connectivity of the brain, the human connectome, is now accessible at millimeter scale with the use of MRI. In this paper, we describe an approach to map the connectome by constructing normalized whole-brain structural connection matrices derived from diffusion MRI tractography at 5 different scales. Using a template-based approach to match cortical landmarks of different subjects, we propose a robust method that allows (a) the selection of identical cortical regions of interest of desired size and location in different subjects with identification of the associated fiber tracts (b) straightforward construction and interpretation of anatomically organized whole-brain connection matrices and (c) statistical inter-subject comparison of brain connectivity at various scales. The fully automated post-processing steps necessary to build such matrices are detailed in this paper. Extensive validation tests are performed to assess the reproducibility of the method in a group of 5 healthy subjects and its reliability is as well considerably discussed in a group of 20 healthy subjects.

Latent tuberculosis: which test in which situation?

Detection of latent tuberculosis infection (LTBI) is a cost-effective procedure in patients at high risk of developing tuberculosis later and who could benefit from preventive treatment. The commonest situation where screening is indicated is the search for infected contacts of an index case with pulmonary tuberculosis. As a screening procedure the current tendency is to replace the time-honoured tuberculin skin test by one of the new blood tests measuring the release of interferon gamma by sensitised T lymphocytes after stimulation by specific peptides from M. tuberculosis. The main advantage of the new tests is the absence of interference with BCG and non-tuberculous mycobacteria, which confers high specificity on the test. This allows a more selective choice of persons for whom preventive treatment is indicated. Some controversial issues remain, such as sensitivity in children and immunocompromised subjects, the predictive value of the blood test and interpretation of possible changes in test results over time. The technical aspects required for performance of the tests must be considered.

Influence of misoprostol or prostaglandin E(2) for induction of labor on the incidence of pathological CTG tracing: a randomized trial.

OBJECTIVE: To compare the efficacy and safety of misoprostol (prostaglandin E(1) (PGE(1))) with dinoprostone (prostaglandin E(2) (PGE(2))) for third trimester cervical ripening and labor induction. STUDY DESIGN: Patients requiring induction of labor were randomly assigned to receive either 50 microg of intravaginal misoprostol every 4 h or 0.5 mg of intracervical dinoprostone gel every 6 h. Eligibility criteria included gestation = 36 weeks. Primary outcome was the time interval from induction to delivery; secondary outcomes were mode of delivery, perinatal outcome, and interpretation of cardiotocogram (CTG) records. RESULTS: Two hundred women were randomly enrolled to receive either misoprostol (n = 100) or dinoprostone (n = 100). Time induction-to-delivery at 12, 24 and 48 h and the need for oxytocin were reduced with misoprostol (P < 0.05). Pathological CTG tracing according to FIGO and Melchior scores were more frequent in the misoprostol-treated group (P < 0.001). CONCLUSION: Misoprostol shortened the induction-to-delivery interval, but is associated with a higher incidence of abnormal CTG than prostaglandin E(2).

Assessing Patient's belief on HIV testing before elective surgery: place for improvements in Switzerland

Background and aim of the study: In Switzerland no HIV test is performed without the patient's consent based on a Voluntary Counseling and Testing policy (VCT). We hypothesized that a substantial proportion of patients going through an elective surgery falsely believed that an HIV test was performed on a routine basis and that the lack of transmission of result was interpreted as being HIV negative. Material and method: All patients with elective orthopedic surgery during 2007 were contacted by phone in 2008. A structured questionnaire assessed their belief about routine preoperative blood analysis (glycemia, coagulation capacity, HIV serology and cholesterol) as well as result awareness and interpretation. Variables included age and gender. Analysis were conducted using the software JMP 6.0.3. Results: 1123 patients were included. 130 (12%) were excluded (i.e. unreachable, unable to communicate on the phone, not operated). 993 completed the survey (89%). Median age was 51 (16-79). 50% were female. 376 (38%) patients thought they had an HIV test performed before surgery but none of them had one. 298 (79%) interpreted the absence of result as a negative HIV test. A predictive factor to believe an HIV test had been done was an age below 50 years old (45% vs 33% for 16-49 years old and 50-79 years old respectively, p <0.001). No difference was observed between genders. Conclusion: In Switzerland, nearly 40% of the patients falsely thought an HIV test had been performed on a routine basis before surgery and were erroneously reassured about their HIV status. These results should either improve the information given to the patient regarding preoperative exams, or motivate public health policy to consider HIV opt-out screening, as patients are already expecting it.

Psykologinen sopimus: työntekijän näkökulma

Työsopimusta solmittaessa syntyy työntekijänja työnantajan välille, kuin huomaamatta myös psykologinen sopimus. Tutkimuksentavoitteena on selvittää millaisia ovat kohdeyrityksen työntekijöiden psykologiset sopimukset, rikotaanko näitä sopimuksia ja kuinka työntekijät reagoivat mahdollisiin rikkomuksiin. Tutkimuksen kohderyhmänä on seitsemän työntekijää, jotka työskentelevät suuressa teollisuusyrityksessä Suomessa. Tutkimuksessa käytetty tutkimusmenetelmä on kvalitatiivinen. Tutkimuksen empiirinen aineisto koostuu teemahaastatteluista. Haastatteluissa pyrittiin selvittämään työntekijöiden psykologisiin sopimuksiin liittyviä käsityksiä, kokemuksia ja tulkintoja. Aineiston analyysissa tulkinta pohjautuu käsitteellisessä osiossa esitettyihin käsitteisiin ja malleihin. Tutkimustulosten mukaan haastateltavien työntekijöiden psykologiset sopimukset ovat hyvin transaktionaalisia. Psykologisia sopimuksia on myös rikottu. Rikkomuksiin haastateltavat ovat reagoineet keskustelemalla työnantajan kanssa tai olemalla vaiti ja sopeutumalla tilanteeseen. Rikkomukset ovat myös vaikuttaneet negatiivisesti haastateltavien työkäyttäytymiseen.

Database Rights in Safe European Home: The Path to More Rigorous Protection of Information

1. Introduction "The one that has compiled ... a database, the collection, securing the validity or presentation of which has required an essential investment, has the sole right to control the content over the whole work or over either a qualitatively or quantitatively substantial part of the work both by means of reproduction and by making them available to the public", Finnish Copyright Act, section 49.1 These are the laconic words that implemented the much-awaited and hotly debated European Community Directive on the legal protection of databases,2 the EDD, into Finnish Copyright legislation in 1998. Now in the year 2005, after more than half a decade of the domestic implementation it is yet uncertain as to the proper meaning and construction of the convoluted qualitative criteria the current legislation employs as a prerequisite for the database protection both in Finland and within the European Union. Further, this opaque Pan-European instrument has the potential of bringing about a number of far-reaching economic and cultural ramifications, which have remained largely uncharted or unobserved. Thus the task of understanding this particular and currently peculiarly European new intellectual property regime is twofold: first, to understand the mechanics and functioning of the EDD and second, to realise the potential and risks inherent in the new legislation in economic, cultural and societal dimensions. 2. Subject-matter of the study: basic issues The first part of the task mentioned above is straightforward: questions such as what is meant by the key concepts triggering the functioning of the EDD such as presentation of independent information, what constitutes an essential investment in acquiring data and when the reproduction of a given database reaches either qualitatively or quantitatively the threshold of substantiality before the right-holder of a database can avail himself of the remedies provided by the statutory framework remain unclear and call for a careful analysis. As for second task, it is already obvious that the practical importance of the legal protection providedby the database right is in the rapid increase. The accelerating transformationof information into digital form is an existing fact, not merely a reflection of a shape of things to come in the future. To take a simple example, the digitisation of a map, traditionally in paper format and protected by copyright, can provide the consumer a markedly easier and faster access to the wanted material and the price can be, depending on the current state of the marketplace, cheaper than that of the traditional form or even free by means of public lending libraries providing access to the information online. This also renders it possible for authors and publishers to make available and sell their products to markedly larger, international markets while the production and distribution costs can be kept at minimum due to the new electronic production, marketing and distributionmechanisms to mention a few. The troublesome side is for authors and publishers the vastly enhanced potential for illegal copying by electronic means, producing numerous virtually identical copies at speed. The fear of illegal copying canlead to stark technical protection that in turn can dampen down the demand for information goods and services and furthermore, efficiently hamper the right of access to the materials available lawfully in electronic form and thus weaken the possibility of access to information, education and the cultural heritage of anation or nations, a condition precedent for a functioning democracy. 3. Particular issues in Digital Economy and Information Networks All what is said above applies a fortiori to the databases. As a result of the ubiquity of the Internet and the pending breakthrough of Mobile Internet, peer-to-peer Networks, Localand Wide Local Area Networks, a rapidly increasing amount of information not protected by traditional copyright, such as various lists, catalogues and tables,3previously protected partially by the old section 49 of the Finnish Copyright act are available free or for consideration in the Internet, and by the same token importantly, numerous databases are collected in order to enable the marketing, tendering and selling products and services in above mentioned networks. Databases and the information embedded therein constitutes a pivotal element in virtually any commercial operation including product and service development, scientific research and education. A poignant but not instantaneously an obvious example of this is a database consisting of physical coordinates of a certain selected group of customers for marketing purposes through cellular phones, laptops and several handheld or vehicle-based devices connected online. These practical needs call for answer to a plethora of questions already outlined above: Has thecollection and securing the validity of this information required an essential input? What qualifies as a quantitatively or qualitatively significant investment? According to the Directive, the database comprises works, information and other independent materials, which are arranged in systematic or methodical way andare individually accessible by electronic or other means. Under what circumstances then, are the materials regarded as arranged in systematic or methodical way? Only when the protected elements of a database are established, the question concerning the scope of protection becomes acute. In digital context, the traditional notions of reproduction and making available to the public of digital materials seem to fit ill or lead into interpretations that are at variance with analogous domain as regards the lawful and illegal uses of information. This may well interfere with or rework the way in which the commercial and other operators have to establish themselves and function in the existing value networks of information products and services. 4. International sphere After the expiry of the implementation period for the European Community Directive on legal protection of databases, the goals of the Directive must have been consolidated into the domestic legislations of the current twenty-five Member States within the European Union. On one hand, these fundamental questions readily imply that the problemsrelated to correct construction of the Directive underlying the domestic legislation transpire the national boundaries. On the other hand, the disputes arisingon account of the implementation and interpretation of the Directive on the European level attract significance domestically. Consequently, the guidelines on correct interpretation of the Directive importing the practical, business-oriented solutions may well have application on European level. This underlines the exigency for a thorough analysis on the implications of the meaning and potential scope of Database protection in Finland and the European Union. This position hasto be contrasted with the larger, international sphere, which in early 2005 does differ markedly from European Union stance, directly having a negative effect on international trade particularly in digital content. A particular case in point is the USA, a database producer primus inter pares, not at least yet having aSui Generis database regime or its kin, while both the political and academic discourse on the matter abounds. 5. The objectives of the study The above mentioned background with its several open issues calls for the detailed study of thefollowing questions: -What is a database-at-law and when is a database protected by intellectual property rights, particularly by the European database regime?What is the international situation? -How is a database protected and what is its relation with other intellectual property regimes, particularly in the Digital context? -The opportunities and threats provided by current protection to creators, users and the society as a whole, including the commercial and cultural implications? -The difficult question on relation of the Database protection and protection of factual information as such. 6. Dsiposition The Study, in purporting to analyse and cast light on the questions above, is divided into three mainparts. The first part has the purpose of introducing the political and rationalbackground and subsequent legislative evolution path of the European database protection, reflected against the international backdrop on the issue. An introduction to databases, originally a vehicle of modern computing and information andcommunication technology, is also incorporated. The second part sets out the chosen and existing two-tier model of the database protection, reviewing both itscopyright and Sui Generis right facets in detail together with the emergent application of the machinery in real-life societal and particularly commercial context. Furthermore, a general outline of copyright, relevant in context of copyright databases is provided. For purposes of further comparison, a chapter on the precursor of Sui Generi, database right, the Nordic catalogue rule also ensues. The third and final part analyses the positive and negative impact of the database protection system and attempts to scrutinize the implications further in the future with some caveats and tentative recommendations, in particular as regards the convoluted issue concerning the IPR protection of information per se, a new tenet in the domain of copyright and related rights.

Quelle perception ont les médecins de famille en Suisse de leur rôle dans la prévention et la promotion de la santé? : comprendre les barrières à l'implémentation

Introduction: The importance of health promotion and prevention and the potential of general practitioners (GPs) to conduct individual prevention procedures have been demonstrated in several studies. Clinical recommendations for screening and prevention activities, an important condition for success, are published regularly, but their implementation into daily practice does not necessarily follow. Information is lacking about the actual conditions of how prevention is carried out on a daily basis by Swiss GPs, about their perceptions and needs, their attitudes and the present barriers they face. Such information is essential for the development of new tools and programs targeting better implementation of clinical recommendations for prevention in primary care in Switzerland. Objectives: The objectives of the study were to analyze how Swiss GPs perceive their role in prevention by obtaining information regarding the following issues: What do disease prevention and health promotion mean to them? What are the current incentives and barriers they face? What are their ideas and suggestions to deal with these barriers? What are their needs and expectations regarding prevention guidelines and tools? Methods: We conducted a qualitative research project using focus groups to examine the questions mentioned above. A total of 13 focus groups took place including GPs from eight cantons: five groups in German- speaking Switzerland and eight in French- speaking Switzerland. Each group was composed of 4-11 GPs, making in total 102 participants, who were paid expenses to cover their participation. The sessions were audio-recorded and transcribed verbatim. Data analysis: Content analysis of the transcriptions began by classifying the data according to a typology, the first level of which was developed in line with the structure of the interview guide. This typology was extended by successively regrouping similar statements. Synopsis and interpretation was then performed on each category thus obtained. This research report is based on the results from the French-speaking cantons. Results: Physicians perceive a change in their role as a consequence of changes in society and the health system. They emphasize the importance of a personalized and long lasting relationship between the family doctor and his/her patient; a privileged position allowing them to perform individualized prevention activities, considered to be more effective, as they are appropriate to the specific situation and needs of the patient. They point out their need for training and for better information concerning prevention and health promotion interventions, and stress difficulties arising from the lack of a clear political signal conferring them with a mandate for prevention. -- INTRODUCTION L'importance de la prévention et de la promotion de la santé et le potentiel des médecins de famillea à mettre en oeuvre des mesures individuelles de prévention, de dépistage et de conseils, a été démontrée dans plusieurs études. Régulièrement durant les dernières années, de nombreuses associations médicales ont publié des recommandations cliniques concernant les activités de dépistage et de prévention qui sont une condition essentielle pour le succès, mais ne sont pas forcément appliquées de manière systématique dans la pratique médicale quotidienne. Des contraintes spécifiques contribuent à l'écart entre le désir des médecins de pratiquer une médecine préventive et la réalité d'un cabinet médical. Nous n'avons que peu de données sur les conditions actuelles dans lesquelles la prévention et la promotion de la santé sont réalisées par les médecins de famille suisses dans leur travail quotidien. Des informations précises et représentatives sur leurs perceptions et leurs besoins, leurs attitudes et les contraintes auxquelles ils sont confrontés manquent. Or ces données sont essentielles dans le développement de nouveaux outils et programmes visant une meilleure implémentation des recommandations cliniques dans le domaine de la prévention et la promotion de la santé dans la médecine de famille en Suisse. OBJECTIFS Le développement de concepts pour une prévention systématique ainsi que d'outils adéquats, tout comme l'amélioration des conditions qui permettent une implémentation à grande échelle, implique, avant tout, l'analyse de la perception que les médecins de famille suisses ont de leur rôle dans la prévention. Par conséquent, cette étude a eu pour objectif d'obtenir des informations concernant les questions suivantes : ? Que signifient la prévention et la promotion de la santé pour les médecins de famille suisses ? ? Quelles sont leurs incitations et les barrières rencontrées ? ? Quelles sont leurs idées et leurs suggestions pour faire face à ces contraintes ? ? Quels sont leurs besoins et leurs attentes concernant les outils pour la prévention ? METHODES Nous avons mené un projet de recherche qualitative en utilisant la technique des focus groups pour examiner les questions mentionnées ci-dessus. Une telle technique de collecte de données est particulièrement adaptée à un domaine où l'on connaît mal les perceptions des parties prenantes. Nous avons mené 13 focus groups au total, comprenant des médecins issus de huit cantons: cinq groupes ont eu lieu en Suisse alémanique et huit groupes en Suisse romande. Chaque groupe était composé de 4 à 11 médecins de famille, avec au total 102 participants qui ont été défrayés pour leur participation. Les séances ont été audio-enregistrées et transcrites. ANALYSE DES DONNEES L'analyse du contenu des transcriptions a commencé par la classification des données selon une typologie dont le premier niveau a été développé à partir de la structure de la grille d'entretiens. Cette typologie a été affinée et élargie en regroupant successivement des propos similaires. Une synthèse a été effectuée pour chaque catégorie. Ce rapport est basé sur les résultats de l'analyse des données des cantons francophones. RESULTATS Les médecins perçoivent un changement de leur rôle dans une société et dans un système de santé qui évoluent. Ils soulignent l'importance de la relation personnalisée et durable du médecin de famille avec son patient, atout précieux, qui leur permet de réaliser des activités de prévention individualisées et adaptées à la situation et aux besoins du patient, considérées plus efficaces. Afin de surmonter leur doutes et découragement par rapport aux interventions de prévention, ils pointent la nécessité d'une formation aux nouvelles connaissances en prévention et promotion de la santé et d'une meilleure information aux médecins quant à leur efficacité et importance. Ils montrent le besoin d'un signal clair des politiques par rapport à l'attribution de ce mandat aux médecins de famille et de leur reconnaissance en tant qu'acteur de prévention dans le système de santé.

Elinkaariarviointi ympäristömyötäisen tuotesuunnittelun tavoitteiden asettamisen tukena

Diplomityössä tutkittiin elinkaariarvioinnin ja sillä saatavien tulosten käyttöä ympäristömyötäisen tuotesuunnittelun tukena. Työn alussa kuvaillaan niitä asioita, jotka yhdistävät yrityksen ympäristöasioihin. Työn aikana suoritettiin kahden yritysten tuotteille elinkaariarvioinnit. Näistä tutkimuksista saatuja käytännön kokemuksia on käytetty diplomityössä. Pääpainopiste käytännön kokemuksissa oli itse elinkaariarvioinnin tekemisessä esille tulleissa seikoissa sekä tulosten tulkinnassa ympäristömyötäisen tuotesuunnittelun tavoitteiden asettamisen näkökulmasta. Ympäristömyötäisen tuotesuunnittelun tavoitteet ovat: materiaali- ja energiakulutuksen vähentäminen, kierrätettävyyden parantaminen, tuotteen käyttöiän pidentäminen ja ympäristölle haitallisten raaka-aineiden välttäminen. Jokaisella ympäristömyötäisen tuotesuunnittelun tavoitteella on oma erityispiirteensä, joka on huomioitava elinkaariarviointia käytettäessä. Työn aikana havaittiin, että erityinen huomio on kiinnitettävä lähtötietojen keruuvaiheeseen. Vielä nykyään on vaikea saada, etenkin alihankkijoilta, kaikkia tarvittavia inventaariotietoja. Tähän elinkaariarvioinnin suorittamisen kannalta ratkaisevaan vaiheeseen, on kaikkien osapuolten kiinnitettävä tulevaisuudessa huomiota. Myös tulosten tulkintaan kiinnitettiin huomioita. Merkittävien tekijöiden ja niihin vaikutusmahdollisuuksien havaitseminen on tärkeä osa tavoitteiden asettamista. Hyvin perusteltujen tavoitteiden asettamisen edellytys on kattavat ja luotettavat elinkaariarvioinnin tulokset. Nämä taas edellyttävät riittävän laajoja, laadukkaita ja yhdenmukaisia lähtötietoja, joita vielä nykyään on harvoin saatavilla.

Validity of the FACIT-Sp to assess spiritual well-being in elderly patients

Among instruments measuring spiritual well-being, the Functional Assessment of Chronic Illness Therapy-Spiritual well-being (FACIT-Sp-12) is the most widely used instrument in research. It has been validated in patients suffering from cancer or HIV/AIDS, but has rarely been used in elderly patients. The objectives of this study were to determine the psychometric properties and suitability of the FACIT-Spto assess spiritual well-being in hospitalized elderly patients. This cross-sectional study uses a mixed method approach. Subjects were patients (N = 208), aged 65 years and older, consecutively admitted in post-acute rehabilitation. Psychometric properties of the FACITSp were investigated. The internal structure of the FACIT-Sp (factor structure and internal consistency) was assessed. Convergent validity of the FACIT-Sp was assessed using the Spiritual Distress Assessment Tool (SDAT), the question "Are you at peace?" and the Geriatric Depression Scale (GDS). Predictive validity was assessed using length of stay (LOS) and discharge destination. Understanding and interpretation of FACIT-Sp items were consecutively assessed in a sub-sample of 135 patients. Results show that FACIT-Sp scores ranged from 7 to 46 (mean 29.6 ± 7.8); 23.1% of the patients had high spiritual well-being. Cronbach's α was g ood ( 0.85). Item-to-total correlations were all significant (0.34 to 0.73). Principal component analyses performed with 2 or 3 factors were only moderately consistent with previous work. FACIT-Sp correlated with SDAT, "Are you at peace?" and GDS (Rho = −0.45, P < 0.001; 0.51, P < 0.001 and −0.38, P < 0.001). No association was found with LOS or discharge destination. Spontaneous comments about one or more FACIT-Sp items were made by 97/135 (71.9%). Specifically, items that address purpose and meaning in life were frequently found difficult to answer. Analyses suggest that the FACIT-Sp may underestimate spiritual well-being in older patients. In conclusion, despite having acceptable psychometric properties, the FACIT-Sp presents limitations for measurement of spiritual well-being in hospitalized elderly patients.

Approaches to the study of individual–landscape interaction as an evocation of intrapersonal communication Aproximaciones al estudio de la interacción individuo-paisaje a modo de evocación comunicativa intrapersonal

Analysis of the interaction between landscape and the individual opens up many research avenues linked to the generation and interpretation of symbolisms and imaginaries. The capacity of landscape for significant and/or communicative evocation finds in intrapersonal communication a relevant argument for the construction of a theoretical framework to study the process of appropriation and experience of the landscape in terms of communicative expression. The principal aim of this paper is to set up the theoretical framework that enables us to interpret the language of landscape and to decode its intangible discourse.

Luottamuksen rooli asiakaslähtöisessä myyntitoiminnassa. Case: Kymen Viestintä Oy - myyntiryhmä

Tutkielman tarkoitus oli selvittää luottamuksen rakentumista asiakkaan ja myyjän välillä vuorovaikutustilanteissa kuten myyntineuvotteluissa. Keskeistä tarkastelussa olivat sujuvan vuorovaikutuksen vaatimukset, luottamuksen rakentaminen ja asiakastyytyväisyys. Työssä etsittiin myös käytännön keinoja luottamuksen rakentamiseen ja asiakkaan tyytyväiseksi saamiseen. Tutkimus toteutettiin case-tutkimuksena puolistrukturoiduilla teemahaastatteluilla. Haastateltavina olivat kaikki ilmoitusmyyntiryhmän jäsenet. Haastatteluja tehtiin yhteensä 6 kappaletta. Analyysi, tulokset ja johtopäätökset perustuivat tutkimuksen tekijän omiin tulkintoihin, jotka perustuivat haastatteluista saatujen havaintojen vertailusta teoriaan. Tutkimuksen tuloksena oli, että luottamusta asiakkaan ja myyjän välille rakentaa ammattitaito, lupausten pitäminen, yhteiset tavoitteet, onnistumiset, dialogi ja tiedon jakaminen. Luottamuksen avulla myyjä saa aikaan vuorovaikutuksessa myös asiakastyytyväisyyttä. Asiakastyytyväisyys lisää vuorostaan luottamusta asiakassuhteessa ja helpottaa vuorovaikutusta.

Participation rates for organized colorectal cancer screening programmes: an international comparison.

OBJECTIVE: Participation, an indicator of screening programme acceptance and effectiveness, varies widely in clinical trials and population-based colorectal cancer (CRC) screening programmes. We aimed to assess whether CRC screening participation rates can be compared across organized guaiac fecal occult blood test (G-FOBT)/fecal immunochemical test (FIT)-based programmes, and what factors influence these rates. METHODS: Programme representatives from countries participating in the International Cancer Screening Network were surveyed to describe their G-FOBT/FIT-based CRC screening programmes, how screening participation is defined and measured, and to provide participation data for their most recent completed screening round. RESULTS: Information was obtained from 15 programmes in 12 countries. Programmes varied in size, reach, maturity, target age groups, exclusions, type of test kit, method of providing test kits and use, and frequency of reminders. Coverage by invitation ranged from 30-100%, coverage by the screening programme from 7-67.7%, overall uptake/participation rate from 7-67.7%, and first invitation participation from 7-64.3%. Participation rates generally increased with age and were higher among women than men and for subsequent compared with first invitation participation. CONCLUSION: Comparisons among CRC screening programmes should be made cautiously, given differences in organization, target populations, and interpretation of indicators. More meaningful comparisons are possible if rates are calculated across a uniform age range, by gender, and separately for people invited for the first time vs. previously.

Tietämyksen hallinta ja tietopääoma liiketoiminnassa – case ABC-liikennemyymäläketju

Tässä tutkimuksessa tutkittiin tietämyksen hallintaa, tietopääomaa ja niiden ilmentymiä liiketoiminnassa. Tutkimuksen avulla pyrittiin selvittämään, pystytäänkö tutkimukseen valittujen mallien avulla määrittelemään S-ryhmään kuuluvan ABC-liikennemyymäläketjun liiketoiminnan kannalta oleellinen tietämyksen hallinta ja tietopääoma. Tutkimus toteutettiin case-tutkimuksena puolistrukturoiduilla teemahaastatteluilla. Haastatteluja tehtiin yhteensä 13 kappaletta. Analyysi, tulokset ja johtopäätökset perustuivat tutkimuksen tekijän omiin tulkintoihin, jotka perustuivat haastatteluista saatujen havaintojen vertailusta teoriaan ja muihin sivutietolähteisiin. Tutkimus osoitti, että tietämyksen hallinnan ja tietopääoman määrittely kyettiin tekemään, mutta lopputulos ei ollut lähtökohtamallin mukainen. Itse määrittelyprosessi ei ollut helppo toteuttaa, mikä johtui tietämyksen hallinnan ja tietopääoman eri osa-alueiden laajuudesta, päällekkäisyydestä, käsitteiden ja aihepiirin vieraudesta haastateltaville. Tutkimuksen oleellisin tulos oli se, että lähtökohtamalliin tehtiin muutoksia tietopääoman osa-alueelle: 1. aineettomaan varallisuuteen lisättiin ”organisaatio” ja poistettiin ”tekniset järjestelmät”, 2. organisaation osaamiseen lisättiin ”verkosto-osaaminen” ja 3. organisaation uudistumiskykyyn lisättiin ”operatiivinen kyvykkyys”. Keskeisin johtopäätös oli, että määritelläkseen liiketoiminnalle ominaisen tietämyksen hallinnan ja tietopääoman ilmentymät, tulee organisaation lähteä liikkeelle yhdestä mallista ja sopia yhteisistä käytettävistä käsitteistä. Organisaatiot ovat eri toimialoilta, joten kaikkia ilmentymiä ei välttämättä esiinny tai löytyy mallissa esiintymättömiä ilmentymiä. Tällöin tulee tehdä muutoksia lähtökohtakohtamalliin.