Polymorphisms in DNA-repair genes in a cohort of prostate cancer patients from different areas in Spain: heterogeneity between populations as a confounding factor in association studies

Background: Differences in the distribution of genotypes between individuals of the same ethnicity are an important confounder factor commonly undervalued in typical association studies conducted in radiogenomics. Objective: To evaluate the genotypic distribution of SNPs in a wide set of Spanish prostate cancer patients for determine the homogeneity of the population and to disclose potential bias. Design, Setting, and Participants: A total of 601 prostate cancer patients from Andalusia, Basque Country, Canary and Catalonia were genotyped for 10 SNPs located in 6 different genes associated to DNA repair: XRCC1 (rs25487, rs25489, rs1799782), ERCC2 (rs13181), ERCC1 (rs11615), LIG4 (rs1805388, rs1805386), ATM (rs17503908, rs1800057) and P53 (rs1042522). The SNP genotyping was made in a Biotrove OpenArrayH NT Cycler. Outcome Measurements and Statistical Analysis: Comparisons of genotypic and allelic frequencies among populations, as well as haplotype analyses were determined using the web-based environment SNPator. Principal component analysis was made using the SnpMatrix and XSnpMatrix classes and methods implemented as an R package. Non-supervised hierarchical cluster of SNP was made using MultiExperiment Viewer. Results and Limitations: We observed that genotype distribution of 4 out 10 SNPs was statistically different among the studied populations, showing the greatest differences between Andalusia and Catalonia. These observations were confirmed in cluster analysis, principal component analysis and in the differential distribution of haplotypes among the populations. Because tumor characteristics have not been taken into account, it is possible that some polymorphisms may influence tumor characteristics in the same way that it may pose a risk factor for other disease characteristics. Conclusion: Differences in distribution of genotypes within different populations of the same ethnicity could be an important confounding factor responsible for the lack of validation of SNPs associated with radiation-induced toxicity, especially when extensive meta-analysis with subjects from different countries are carried out.

Phenol-Explorer 3.0: a major update of the Phenol-Explorer database to incorporate data on the effects of food processing on polyphenol content

Polyphenols are a major class of bioactive phytochemicals whose consumption may play a role in the prevention of a number of chronic diseases such as cardiovascular diseases, type II diabetes and cancers. Phenol-Explorer, launched in 2009, is the only freely available web-based database on the content of polyphenols in food and their in vivo metabolism and pharmacokinetics. Here we report the third release of the database (Phenol-Explorer 3.0), which adds data on the effects of food processing on polyphenol contents in foods. Data on >100 foods, covering 161 polyphenols or groups of polyphenols before and after processing, were collected from 129 peer-reviewed publications and entered into new tables linked to the existing relational design. The effect of processing on polyphenol content is expressed in the form of retention factor coefficients, or the proportion of a given polyphenol retained after processing, adjusted for change in water content. The result is the first database on the effects of food processing on polyphenol content and, following the model initially defined for Phenol-Explorer, all data may be traced back to original sources. The new update will allow polyphenol scientists to more accurately estimate polyphenol exposure from dietary surveys. Database URL: http://www.phenol-explorer.eu

A novel approach to the determination of clinical decision thresholds

Our objective was to determine the test and treatment thresholds for common acute primary care conditions. We presented 200 clinicians with a series of web-based clinical vignettes, describing patients with possible influenza, acute coronary syndrome (ACS), pneumonia, deep vein thrombosis (DVT) and urinary tract infection (UTI). We randomly varied the probability of disease and asked whether the clinician wanted to rule out disease, order tests or rule in disease. By randomly varying the probability, we obtained clinical decisions across a broad range of disease probabilities that we used to create threshold curves. For influenza, the test (4.5% vs 32%, p<0.001) and treatment (55% vs 68%, p=0.11) thresholds were lower for US compared with Swiss physicians. US physicians had somewhat higher test (3.8% vs 0.7%, p=0.107) and treatment (76% vs 58%, p=0.005) thresholds for ACS than Swiss physicians. For both groups, the range between test and treatment thresholds was greater for ACS than for influenza (which is sensible, given the consequences of incorrect diagnosis). For pneumonia, US physicians had a trend towards higher test thresholds and lower treatment thresholds (48% vs 64%, p=0.076) than Swiss physicians. The DVT and UTI scenarios did not provide easily interpretable data, perhaps due to poor wording of the vignettes. We have developed a novel approach for determining decision thresholds. We found important differences in thresholds for US and Swiss physicians that may be a function of differences in healthcare systems. Our results can also guide development of clinical decision rules and guidelines.

Phenotypic and genotypic characteristics of cryopyrin-associated periodic syndrome: a series of 136 patients from the Eurofever Registry.

OBJECTIVE: To evaluate genetic, demographic and clinical features in patients with cryopyrin-associated periodic syndrome (CAPS) from the Eurofever Registry, with a focus on genotype-phenotype correlations and predictive disease severity markers. METHODS: A web-based registry retrospectively collected data on patients with CAPS. Experts in the disease independently validated all cases. Patients carrying NLRP3 variants and germline-mutation-negative patients were included. RESULTS: 136 patients were analysed. The median age at disease onset was 9 months, and the median duration of follow-up was 15 years. Skin rash, musculoskeletal involvement and fever were the most prevalent features. Neurological involvement (including severe complications) was noted in 40% and 12% of the patients, respectively, with ophthalmological involvement in 71%, and neurosensory hearing loss in 42%. 133 patients carried a heterozygous, germline mutation, and 3 patients were mutation-negative (despite complete NLRP3 gene screening). Thirty-one different NLRP3 mutations were recorded; 7 accounted for 78% of the patients, whereas 24 rare variants were found in 27 cases. The latter were significantly associated with early disease onset, neurological complications (including severe complications) and severe musculoskeletal involvement. The T348M variant was associated with early disease onset, chronic course and hearing loss. Neurological involvement was less strongly associated with V198M, E311 K and A439 V alleles. Early onset was predictive of severe neurological complications and hearing loss. CONCLUSIONS: Patients carrying rare NLRP3 variants are at risk of severe CAPS; onset before the age of 6 months is associated with more severe neurological involvement and hearing loss. These findings may have an impact on treatment decisions.

State of Logistics and Operations Management in Finnish and Swedish Companies – Survey Research Findings

In this research we are examining what is the status of logistics and operations management in Finnish and Swedish companies. Empirical data is based on the web based questionnaire, which was completed in the end of 2007 and early 2008. Our examination consists of roughly 30 answers from largest manufacturing (highest representation in our sample), trade and logistics/distribution companies. Generally it could be argued that these companies operate in complex environment, where number of products, raw materials/components and suppliers is high. However, usually companies rely on small amount of suppliers per raw material/component (highest frequency is 2), and this was especially the case among Swedish companies, and among those companies, which favoured overseas sourcing. Sample consisted of companies which mostly are operating in an international environment, and are quite often multinationals. Our survey findings reveal that companies in general have taken logistics and information technology as part of their strategy process; utilization of performance measures as well as system implementations have followed the strategy decisions. In the transportation mode side we identify that road transports dominate all transport flow classes (inbound, internal and outbound), followed by sea and air. Surprisingly small amount of companies use railways, but in general we could argue that Swedish companies prefer this mode over Finnish counterparts. With respect of operations outsourcing, we found that more traditional areas of logistics outsourcing are driving factors in company's performance measurement priority. In contrary to previous research, our results indicate that the scope of outsourcing is not that wide in logistics/operations management area, and companies are not planning to outsource more in the near future. Some support is found for more international operations and increased outsourcing activity. From the increased time pressure of companies, we find evidence that local as well as overseas customers expect deliveries within days or weeks, but suppliers usually supply within weeks or months. So, basically this leads into considerable inventory holding. Interestingly local and overseas sourcing strategy does not have that great influence on lead time performance of these particular sourcing areas - local strategy is anyway considerably better in responding on market changes due to shorter supply lead times. In the end of our research work we have completed correlation analysis concerning items asked with Likert scale. Our analysis shows that seeing logistics more like a process rather than function, applying time based management, favouring partnerships and measuring logistics within different performance dimensions results on preferred features and performance found in logistics literature.

Effects of business-to-business customer orientation, satisfaction and retention on firm profitability

The objective of this master’s thesis was to examine the effect of customer orientation on customer satisfaction and how customer satisfaction and customer retention contribute to firm profitability. Beside customer orientation, also other antecedents of customer satisfaction, i.e. service quality, flexibility, trust and commitment, were investigated as control variables. Literature review revealed several research gaps concerning research of the key concepts. These research calls were also answered. The empirical study focused on one case company, a telecommunication expert. The data for the empirical part was collected with web-based questionnaire from case company’s business customers in January-February 2008. Sample (N=95) produced 59 answers, thus the response rate of the survey was 62,1%. The data was analyzed by using statistical analysis program, SPSS. As a conclusion, the results indicate that customer orientation do not affect customer satisfaction directly, but through service quality, flexibility and trust. Moreover, customer satisfaction has positive impacts on commitment and intentions to stay as a customer in the future, but not on profitability. In the present study, only past purchase behavior, measured with customer database measure, is positively related to firm profitability.

Sähköisen taloushallinnon vaikutus tilitoimistojen tuottavuuteen Case: Heeros Systems Oy

Tässä tutkimuksessa tarkasteltiin tuottavuuden käsitettä ja mittaamista palvelualoilla. Tutkielman tavoitteena oli kuvata ja ymmärtää sähköisen taloushallinnon vaikutusta tilitoimistojen tuottavuuteen. Aihetta lähestyttiin sähköisiä taloushallinto-ohjelmia valmistavan case-yhtiö Heeros Systems Oy:n avulla. Tutkimus on luonteeltaan laadullinen tutkimus, jonka tutkimusmenetelmä-nä käytettiin teemahaastatteluja. Tutkimusaineisto kerättiin haastattelemal-la yhteensä kymmentä tutkimuksen kohteena olevan tilitoimiston edusta-jaa. Tutkimuksen perusteella ei havaittu sähköisen taloushallinnon selkeästi vaikuttavan tilitoimistojen tuottavuuteen tässä vaiheessa, mutta toiminto-ympäristön sähköistyessä, esimerkiksi verkkolaskujen yleistyessä, tilan-teen uskotaan muuttuvan nopeasti. Tällöin tuottavuuden kasvu edellyttää työprosessin muuttamista ja huolellista suunnittelua.

Gestión de la actividad no presencial y autoevaluación de competencias = Management of Student Learning Outside the Classroom and the Self-evaluation of Competences

Psychological Assessment is a core subject of Psychology studies, and of the university degree Human development, at the University of Girona and according to the University regulations, had 12 credits. Until the 2005-06 academic years, the student work conducted outside the classroom consisted of undertaking a psychological assessment that was written and handed in at the end of the course. From this the student obtained a qualification and a review if they applied for it In accordance with the European Credits for Higher Education, this subject was reduced to 9 credits, which is the equivalent of a total of 255 hours of in-class work and outside the classroom. In the 2006-07 academic year we created a guide to manage the student’s experiences outside the classroom, with the objective of encouraging the application of problem solving/critical thinking (Bloom, 1975), in line with the recommendations of the Catalonia Agency for University System Quality (2005). The guide includes: learning objectives, evaluation criterions, a description of activities, work week timetable for the whole course, programmed tutorials to review all steps of the psychological assessment process, and the use of a web-based virtual forum for the transfer of knowledge, analysis and constructive critiques of the assessment done by themselves and their colleagues

Building distributed high availability system

Today’s commercial web sites are under heavy user load and they are expected to be operational and available at all times. Distributed system architectures have been developed to provide a scalable and failure tolerant high availability platform for these web based services. The focus on this thesis was to specify and implement resilient and scalable locally distributed high availability system architecture for a web based service. Theory part concentrates on the fundamental characteristics of distributed systems and presents common scalable high availability server architectures that are used in web based services. In the practical part of the thesis the implemented new system architecture is explained. Practical part also includes two different test cases that were done to test the system's performance capacity.

Cross-Cultural Communication in Oncology: Challenges and Training Interests.

PURPOSE/OBJECTIVES: To survey oncology nurses and oncologists about difficulties in taking care of culturally and linguistically diverse patients and about interests in cross-cultural training.
. DESIGN: Descriptive, cross-sectional.
. SETTING: Web-based survey.
. SAMPLE: 108 oncology nurses and 44 oncologists. 
. METHODS: 31-item questionnaire derived from preexisting surveys in the United States and Switzerland.
. MAIN RESEARCH VARIABLES: Self-rated difficulties in taking care of culturally and linguistically diverse patients and self-rated interests in cross-cultural training.
. FINDINGS: All respondents reported communication difficulties in encounters with culturally and linguistically diverse patients. Respondents considered the absence of written materials in other languages, absence of a shared common language with patients, and sensitive subjects (e.g., end of life, sexuality) to be particularly problematic. Respondents also expressed a high level of interest in all aspects of cross-cultural training (task-oriented skills, background knowledge, reflexivity, and attitudes). Nurses perceived several difficulties related to care of migrants as more problematic than physicians did and were more interested in all aspects of cross-cultural training. 
. CONCLUSIONS: The need for cross-cultural training is high among oncology clinicians, particularly among nurses.
. IMPLICATIONS FOR NURSING: The results reported in the current study may help nurses in decision-making positions and educators in introducing elements of cross-cultural education into oncology curricula for nurses. Cross-cultural training should be offered to oncology nurses.

Portal intercanvi de cases

Portal web sobre intercanvis de cases en tecnologia ASP.NET MVC amb Visual Studio 2012.

Variation in Current Management of Term and Late-preterm Neonates at Risk for Early-onset Sepsis: An International Survey and Review of Guidelines.

BACKGROUND: Uncertainty about the presence of infection results in unnecessary and prolonged empiric antibiotic treatment of newborns at risk for early-onset sepsis (EOS). This study evaluates the impact of this uncertainty on the diversity in management. METHODS: A web-based survey with questions addressing management of infection risk-adjusted scenarios was performed in Europe, North America, and Australia. Published national guidelines (n = 5) were reviewed and compared with the results of the survey. RESULTS: 439 Clinicians (68% were neonatologists) from 16 countries completed the survey. In the low-risk scenario, 29% would start antibiotic therapy and 26% would not, both groups without laboratory investigations; 45% would start if laboratory markers were abnormal. In the high-risk scenario, 99% would start antibiotic therapy. In the low-risk scenario, 89% would discontinue antibiotic therapy before 72 hours. In the high-risk scenario, 35% would discontinue therapy before 72 hours, 56% would continue therapy for 5-7 days, and 9% for more than 7 days. Laboratory investigations were used in 31% of scenarios for the decision to start, and in 72% for the decision to discontinue antibiotic treatment. National guidelines differ considerably regarding the decision to start in low-risk and regarding the decision to continue therapy in higher risk situations. CONCLUSIONS: There is a broad diversity of clinical practice in management of EOS and a lack of agreement between current guidelines. The results of the survey reflect the diversity of national guidelines. Prospective studies regarding management of neonates at risk of EOS with safety endpoints are needed.

On-line life history calendar and sensitive topics : A pilot study

The use of the life history calendar (LHC) or the event history calendar as tools for collecting retrospective data has received increasing attention in many fields of social science and medicine. However, little research has examined the use of this method with web-based surveys. In this study, we adapted this method to an on-line setting to collect information about young adults' life histories, sexual behaviors, and substance use. We hypothesized that the LHC method would help respondents to date sensitive and non-sensitive events more precisely than when using a conventional questionnaire. We conducted an experimental design study comparing university students' responses to an on-line LHC and a conventional on-line question list. A test-retest design in which the respondents completed the survey again two weeks later was also applied to test the precision and reliability of the participants' dating of events. The results showed that whereas the numbers of sensitive and non-sensitive events were generally similar for the two on-line questionnaires, the responses obtained with the LHC were more consistent across the two administrations. Analyses of the respondents' on-line behavior while completing the LHC confirmed that respondents used the LHC's graphic interface to correct and reedit previous answers, thus decreasing data errors. (C) 2015 Elsevier Ltd. All rights reserved.

La prévention du tabagisme et les facteurs organisationnels en médecine générale: une étude pilote en Suisse romande

Context: Several studies have been carried out to describe how general practitioners (GPs) follow smoking cessation counseling's recommendations and to identify GP-related factors that influence their practice. But limited information exists about practice organization's elements influencing smoking counseling and more generally about prevention activities in primary care (PC) in Switzerland. Objectives: Explore the feasibility of this study. Investigate determinants of PC practices associated with smoking cessation counseling in Switzerland. Explore the GP's attitude towards prevention and the organizational characteristics of PC practices. Design: Pilot Web-based survey in a representative sample of Swiss French speaking GPs. Results : 44 GP's responded; 66% were men; mean age = 57.5 years; 59% were in group practices; 1 GP was currently smoking and 32% were ex-smokers; 57% of GPs found very important to perform health prevention activities. 57% of GPs were trained (>5 hours throughout the career) to provide smoking cessation counseling. 84% of GP's always inquire about smoking status during first consultations, compared to 69% during emergency consultations for respiratory symptoms and only 9% during non-respiratory emergency consultation. Factors positively associated with smoking status inquiring were: young age (<57.5) of GP's for first consultations, rural location and solo practice for emergency consultations. Smoking cessation counseling is systematically provided by 48% of GPs during emergency consultations for respiratory symptoms and by 20% of GPs during follow-up consultations. Factor positively associated with smoking cessation counseling was solo practice. Discussion: In Switzerland, there are missed opportunities to provide smoking cessation counseling, especially in emergency situations, possibly in people who have rarely contacts with the health care system. Despite a small sample, this study showed the potential associations between organizational and GP-related factors and smoking cessation counseling. These findings will be further explored in a national study among 200 GPs' practices.

Individual Perception of Organizational Values

The objective of this master’s thesis was to examine how corporate values come true among the white-collar employees in the case organization. It was also studied if values were perceived similarly in the different departments. Impact of organizational position and education on value orientation was tested through hypotheses based on earlier values research. There are only few value scales available for measuring organizational values. The empirical study results indicate that personnel’s perception of organizational values can be measured statistically. When defining the scale it is utmost important to link the questions and claims close to the employees’ daily working environment. In this study, Work ethic appeared as the strongest organizational value reflecting respondents’ commitment to their duties. Related to corporate values, Performance was perceived as the strongest value and Emphasis on people the weakest. Value consensus between the departments varied. According to the previous research organizational position and educational level has an impact on value perceptions. In this study, employees in superior position or with higher education perceived organizational values to come true better than subordinates or employees with lower education. Empirical data (N=229) was collected by a web-based survey questionnaire among white-collar employees in the case organization in April 2008. Statistical analyses were performed by SPSS programme.