Secondary prevention of type 1 diabetes mellitus: stopping immune destruction and promoting ß-cell regeneration

Type 1 diabetes mellitus results from a cell-mediated autoimmune attack against pancreatic ß-cells. Traditional treatments involve numerous daily insulin dosages/injections and rigorous glucose control. Many efforts toward the identification of ß-cell precursors have been made not only with the aim of understanding the physiology of islet regeneration, but also as an alternative way to produce ß-cells to be used in protocols of islet transplantation. In this review, we summarize the most recent studies related to precursor cells implicated in the regeneration process. These include embryonic stem cells, pancreas-derived multipotent precursors, pancreatic ductal cells, hematopoietic stem cells, mesenchymal stem cells, hepatic oval cells, and mature ß-cells. There is controversial evidence of the potential of these cell sources to regenerate ß-cell mass in diabetic patients. However, clinical trials using embryonic stem cells, umbilical cord blood or adult bone marrow stem cells are under way. The results of various immunosuppressive regimens aiming at blocking autoimmunity against pancreatic ß-cells and promoting ß-cell preservation are also analyzed. Most of these regimens provide transient and partial effect on insulin requirements, but new regimens are beginning to be tested. Our own clinical trial combines a high dose immunosuppression with mobilized peripheral blood hematopoietic stem cell transplantation in early-onset type 1 diabetes mellitus.

Inviting the Audience – Interactive, Participatory, and Social Television in Finland

The television and the ways it has invited the audience to take part have been changing during the last decade. Today’s interaction, or rather participation, comes from multiplatform formats, such as TV spectacles that combine TV and web platforms in order to create a wider TV experience. Multiplatform phenomena have spread television consumption and traditional coffee table discussions to several different devices and environments. Television has become a part of the bigger puzzle of interconnected devices that operates on several platforms instead of just one. This thesis examines the Finnish television (2004–2014) through the notion of audience participation and introduces the technical, thematic, and social linkages as three different phases, interactive, participatory, social, and their most characteristic features in terms of audience participation. The aim of the study is also to focus on the idea of a possible change by addressing the possible and subtler variations that have taken place through the concept of digital television. Firstly, Finnish television history has gone through numerous trials, exploring the interactive potential of television formats. Finnish SMS-based iTV had its golden era around 2005, when nearly 50% of the television formats were to some extent interactive. Nowadays, interactive television formats have vanished due to their negative reputation and this important part of recent history is mainly been neglected in the academic scope. The dissertation focuses also on the present situation and the ways television content invites the audience to take part. “TV meets the Internet” is a global expression that characterises digital TV, and the use of the Web combined with television content is also examined. Also the linkages between television and social media are identified. Since television can nowadays be described multifaceted, the research approaches are also versatile. The research is based on qualitative content analysis, media observation, and Internet inquiry. The research material also varies. It consists of primary data: taped iTV formats, website material, and social media traces both from Twitter and Facebook and secondary data: discussion forums, observations from the media and Internet inquiry data. To sum up the results, the iTV phase represented, through its content, a new possibility for audiences to take part in a TV show (through gameful and textual features) in real-time. In participatory phase, the most characteristic features from TV-related content view, is the fact that online platform(s) were used to immerse the audience with additional material and, due to this, to extend the TV watching enjoyment beyond the actual broadcast. During the Social (media) phase, both of these features, real-timeness, and extended enjoyment through additional material, are combined and Facebook & Twitter, for example, are used to immerse people in live events (in real-time) via broadcast-related tweets and extra-material offered on a Facebook page. This thesis fills in the gap in Finnish television research by examining the rapid changes taken place on the field within the last ten years. The main results is that the development of Finnish digital television has been much more diverse and subtle than has been anticipated by following only the news, media, and contemporary discourses on the subject of television. The results will benefit both practitioners and academics by identifying the recent history of Finnish television.

Pamidronate for the treatment of osteoporosis secondary to chronic cholestatic liver disease in Wistar rats

Osteoporosis is a major complication of chronic cholestatic liver disease (CCLD). We evaluated the efficacy of using disodium pamidronate (1.0 mg/kg body weight) for the prevention (Pr) or treatment (Tr) of cholestasis-induced osteoporosis in male Wistar rats: sham-operated (Sham = 12); bile duct-ligated (Bi = 15); bile duct-ligated animals previously treated with pamidronate before and 1 month after surgery (Pr = 9); bile duct-ligated animals treated with pamidronate 1 month after surgery (Tr = 9). Rats were sacrificed 8 weeks after surgery. Immunohistochemical expression of IGF-I and GH receptor was determined in the proximal growth plate cartilage of the left tibia. Histomorphometric analysis was performed in the right tibia and the right femur was used for biomechanical analysis. Bone material volume over tissue volume (BV/TV) was significantly affected by CCLD (Sham = 18.1 ± 3.2 vs Bi = 10.6 ± 2.2%) and pamidronate successfully increased bone volume. However, pamidronate administered in a preventive regimen presented no additional benefit on bone volume compared to secondary treatment (BV/TV: Pr = 39.4 ± 12.0; Tr = 41.2 ± 12.7%). Moreover, the force on the momentum of fracture was significantly reduced in Pr rats (Sham = 116.6 ± 23.0; Bi = 94.6 ± 33.8; Pr = 82.9 ± 22.8; Tr = 92.5 ± 29.5 N; P < 0.05, Sham vs Pr). Thus, CCLD had a significant impact on bone histomorphometric parameters and pamidronate was highly effective in increasing bone mass in CCLD; however, preventive therapy with pamidronate has no advantage regarding bone fragility.

Defining Sales and Operations Planning Process in an Environmental Management Company

Sales and operations research publications have increased significantly in the last decades. The concept of sales and operations planning (S&OP) has gained increased recognition and has been put forward as the area within Supply Chain Management (SCM). Development of S&OP is based on the need for determining future actions, both for sales and operations, since off-shoring, outsourcing, complex supply chains and extended lead times make challenges for responding to changes in the marketplace when they occur. Order intake of the case company has grown rapidly during the last years. Along with the growth, new challenges considering data management and information flow have arisen due to increasing customer orders. To manage these challenges, case company has implemented S&OP process, though initial process is in early stage and due to this, the process is not managing the increased customer orders adequately. Thesis objective is to explore extensively the S&OP process content of the case company and give further recommendations. Objectives are categorized into six different groups, to clarify the purpose of this thesis. Qualitative research methods used are active participant observation, qualitative interviews, enquiry, education, and a workshop. It is notable that demand planning was felt as cumbersome, so it is typically the biggest challenge in S&OP process. More proactive the sales forecasting can be, more expanded the time horizon of operational planning will turn out. S&OP process is 60 percent change management, 30 percent process development and 10 percent technology. The change management and continuous improvement can sometimes be arduous and set as secondary. It is important that different people are required to improve the process and the process is constantly evaluated. As well as, process governance is substantially in a central role and it has to be managed consciously. Generally, S&OP process was seen important and all the stakeholders were committed to the process. Particular sections were experienced more important than others, depending on the stakeholders’ point of views. Recommendations to objective groups are evaluated by the achievable benefit and resource requirement. The urgent and easily implemented improvement recommendations should be executed firstly. Next steps are to develop more coherent process structure and refine cost awareness. Afterwards demand planning, supply planning, and reporting should be developed more profoundly. For last, information technology system should be implemented to support the process phases.

Influence of secondary packing on the freezing time of chiken meat in air blast freezing tunnels

Freezing of poultry cuts in continuous convective air blast tunnels is normally performed with the products protected by Low Density Polyethylene (LDPE) as a primary packaging and using Corrugated Cardboard Boxes (CCB) as secondary packaging. The objective of this work was to investigate the influence of these secondary packaging on the freezing of poultry cuts in continuous convective air blast tunnels. The study was performed by replacing CCB with Perforated Metal Boxes (PMB) in order to remove the packaging thermal resistance. The assays, performed in a industrial plant, demonstrated that CCB used commercially for meat freezing have a high heat transfer resistance. Their replacement with PMB can lead to shorter freezing times and spatially homogeneous freezing. Reductions of up to 45% in the freezing times were observed using PMB. The plateau of the temperature curve, related to the freezing time of free water, was significantly reduced using PMB, which is accepted to lead to better product quality after thawing. As the products were protected by the LDPE films as primary packaging, their appearance were not affected. The results presented in this work indicate that replacing CBB with PMB can be an excellent alternative to reduce freezing time and improve freezing homogeneity in industrial air blast tunnels, which could also be applied to other products.

Interactions of decision mechanisms in an entrepreneurial firm’s journey to become a major player in its industry

This study discusses the interactions of different decision-making mechanisms in the process of change of a successful entrepreneurial dairy firm in Vietnam. The purpose of the study is to construct a theoretical framework, which explains the interactions between effectual and causal decision-making processes in different phases of business, and to provide a real life example with practical recommendations for entrepreneurs and managers. In order to achieve this purpose, a preliminary theoretical framework was built, using process theories applied to different decision making modes, referred to as causation and effectuation. The case was studied through ethnographic research method, with three semi-structured interviews, one unstructured interview, secondary data and observations within four months in 2013-2014. After the data was analyzed, a modified framework was drawn from the result. The finding of this study shows that there was an interaction between effectual and causal decision-making processes in different stages of the company’s development. The entrepreneur applied effectual decision-making process to develop a unique business model and a new dairy market segment. However, when a new market demand arose, the company’s resources became insufficient, they thus had to shift to causation process to adapt to market change. Simultaneously, with better-accumulated resources, the entrepreneur continued the effectuation process to create another brand new dairy market segment. This study, thus, contributes to effectuation theory, emphasizing the necessity of combining effectual and causal decision-making processes in different phases of business. It is suggested that business would develop with an effectual process until a business model is viable for growth. It continues to use this process up to a certain degree. When the market changes, the company needs to collect more means to adapt to the changes. They need to set new goals and this is a shift to the use of causal process, which builds on prediction. It uses goals and teleology as driving mechanisms and tries to exploit and fill potential resource gaps to achieve these goals. At the same time, there are new iterations that look to establish new lines or types of business with the given means, which are now well established. This again employs effectual mechanisms, which are based on evolutionary process, until they reach the stage of viable tested business model. Moreover, this study hopes to provide know-how to entrepreneurs and managers of small companies in similar situations, suggesting how to combine effectual and causal decision-making processes to deal with various circumstances in different times.

The challenges and successful strategies of secondary school administrators /

This study presents information gathered during personal interviews in the area of challenges that administrators have faced in their careers, and the strategies they have found to be successful in meeting those challenges. This research is a qualitative study, using an inductive approach. Five participants were chosen, based on convenience sampling, with semi-structured interviews that were audio recorded. The theoretical research found that school violence and stafS'school morale were key challenges facing administrators, with a variety of approaches suggested to foster success in meeting those challenges. Some of these approaches included knowledge, team work, an ethic of care, and having a school vision. From the interviews it became clear that the challenges administrators faced included those posed by students, including disciplinary issues, those posed by adults and those posed by government changes in education. In regards to strategies for success, the interviews revealed three key concepts that were emphasized as vital. These were the assets of craft knowledge (experience), collegiality, and the use of other professional resources and educators.

Evaluating three self-help smoking cessation interventions for post-secondary smokers : a randomized controlled trial on six Ontario campuses

Objective. Smoking prevalence is highest among the young adult cohort. Postsecondary students are no exception. Although many students intend to quit smoking, no research has established what methods best promote reductions in, or complete abstinence from smoking. This randomized controlled trial examined the effectiveness of three self-help smoking cessation interventions. Method. On six post-secondary campuses, 483 smokers who voluntarily accessed Leave The Pack Behind (a tobacco control initiative) were randomly assigned to one of three smoking cessation interventions: One Step At A Time (a 2-booklet, *gold standard' program for adults); Smoke|Quit (a newly-developed 2-booklet program for young adult students); and usual care (a 'Quit Kit' containing a booklet on stress management, information about pharmacological quitting aides and novelty items). All participants also received one proactive telephone support call from a peer counsellor. During the study, 85 participants withdrew. The final sample of 216 students who completed baseline questionnaires and 12-week follow-up telephone interviews was representative of the initial sample in terms of demographic characteristics, and smokingquitting- related variables. Results. Whether participants quit smoking depended upon treatment condition, ^(2, N=2\6) = 6.34, p = .04, with Smoke|Quit producing more successfijl quitters (18.4%) than One Step At A Time (4.5%) or the Quit Kit (1 1.4%). On average, participants had quit 53.46 days, with no significant difference across treatments. Selfefficacy also increased. Use of the intervention or other quitting aides was not associated with treatment condition. Among the 191 participants who did not quit smoking, treatment condition did not influence outcomes. Overall, 46.2% had made a quit attempt. Significant decreases in weekly tobacco consumption and increases in self-efficacy to resist smoking were observed from baseline to follow-up. Conclusion. Post-secondary institutions represent a potentially final opportunity for age-targeted interventions. Self-help resources tailored to students' social and contextual characteristics will have considerable more impact than stage-only tailored interventions. Both reduction and abstinence outcomes should be emphasized to positively support students to stop smoking.

Mentorships and co-op placements as a means of heightening the need for a secondary school diploma to the education of at-risk students.--

Both educators and politicians appear to be quite concerned about a dropout rate in Ontario's public schools of some 30 percent. With the basic understanding that a high dropout rate is costly both in economic terms and in human terms, something quite obviously needs to be done to reduce the dropout rate in Ontario schools and, in doing so, ensuring Ontario and its graduates an active role in a growing global economy. This study is an exploratory pilot study in that it examined mentoring and the role that mentoring can play in assisting a student in staying in school and graduating from secondary school. Also incorporated in this is co-operative education and the role it can play, through mentoring, in making students aware of lifestyle level of employment, and of the skills necessary to obtain gainful, meaningful employment. In order to gain information on student attitudes, needs and expectations of a mentoring situation, a series of three questionnaires was used. Also, a questionnaire was distributed to the various co-operative education employers. The intent of this questionnaire was to probe the attitudes, needs and expectations of a mentoring situation from the perspective of an employer. The findings of this study indicated that co-operative education and mentoring are a very valuable and useful component in education. There exist certain factors in a co-operative education setting that serve to enhance and to augment the traditional or "theoretical" setting of the classroom. In addition, a mentoring situation tends to add a sense of relevance to education that students seem to require. Also, an opportunity is offered that allows a student to practice and further refine the skills that have been taught over the course of the student's academic life. Results from this study suggested that a mentoring situation, occurring through a co-operative education situation, adds relevance and a sense of "application" to the traditional or classroom schooling situation. The whole idea of mentoring bodes well for the future of education and of the student. Many advantages are identified in a mentoring situation. One of the advantages is that the schools are able to work quite closely with the community and business in order to stay current and informed on the needs and expected needs of the business community. Co-operative education has now gone beyond being an "experimental" mode of education. All students can benefit from being involved in the program. Certainly at-risk students are aided with staying in school. Those students who are said to be not at-risk can also benefit from being enrolled in the program by gaining hands-on work experience and some of the necessary skills to ensure a place in a growing world economy.

The nature of bullying among secondary school students /

The purpose of this research was to determine the prevalence and effect of bullying in a secondary school. Six hundred and fifty-nine student volunteers completed a survey which included a quantitative component of 40 questions and 3 questions which required a written response. The results suggest that approximately 1 student in 10 was involved in a bullying situation either as a bully or a victim. As age increased, physical bullying decreased whereas psychological remained high in the senior years of high school. Boys were involved more in bullying than girls, especially in the junior years. The effects of bullying could be devastating to the point of school avoidance or early school leaving. The results also indicate that much of the bullying was not being reported. The implication for the education system is that more needs to be done to prevent bullying, to encourage the reporting of bullying, and to deal with the aftermath of a bullying situation.

A qualitative study of authority from the perspective of secondary school principals /

In this research study I examined how four principals of secondary schools interpreted authority and how these interpretations affected their practice. This study involved a presentation of the literature where the concept of qualitative methodology as well as general concepts of authority were reviewed. Four principals were interviewed and asked to reflect on their feelings and experiences as they related to the practice of authority. Five major themes emerged from their reflections and stories which were: Understandings of the Concept of Authority, Principals' Enactment of Authority, Thoughts and Experiences related to Challenges to Their Authority, A View of Principals' Challenge of Authority, and Changing Views on the Authority of Principals in Ontario. The stories of these four principals demonstrated that the practice of authority is complex, dynamic, and contains personal and social tensions. The sharing of these ideas and stories provided a window into the world of these secondary school educational leaders and their experiences with, and enactment of, authority. From this research four recommendations were made to improve educators' practice related to the issue of authority. The importance of this study is that it presents an understanding of the dynamic nature of the process and enactment of authority by these secondary school principals at a unique time in the history of education in Ontario.This qualitative research provides a snapshot of a particular group of educators at a particular time and place. Others need to add to these understandings and modify these ideas through further research. Understanding the experiences of educational leaders as they negotiate concepts of authority gives a window on this very complex, yet vital, component of education.