The assessment of spirituality and religiousness in schizophrenia.

To assess religious coping in schizophrenia, we developed and tested a clinical grid, as no validated questionnaire exists for this population. One hundred fifteen outpatients were interviewed. Results obtained by 2 clinicians were compared. Religion was central in the lives of 45% of patients, 60% used religion extensively to cope with their illness. Religion is a multifaceted construct. Principal component analysis elicited 4 factors: subjective dimension, collective dimension, synergy with psychiatric treatment, and ease of talking about religion with psychiatrist. Different associations were found between these factors and psychopathology, substance abuse, and psychosocial adaptation. The high prevalence of spirituality and religious coping clearly indicates the necessity of addressing spirituality in patient care. Our clinical grid is suitable for this purpose. It proved its applicability to a broad diversity of religious beliefs, even pathological ones. Interjudge reliability and construct validity were high and specific training is not required.

Laparoscopy in the era of enhanced recovery.

Laparoscopy is one of the cornerstones in the surgical revolution and transformed outcome and recovery for various surgical procedures. Even if these changes were widely accepted for basic interventions, like appendectomies and cholecystectomies, laparoscopy still remains challenged for more advanced operations in many aspects. Despite these discussion, there is an overwhelming acceptance in the surgical community that laparoscopy did transform the recovery for several abdominal procedures. The importance of improved peri-operative patient management and its influence on outcome started to become a focus of attention 20 years ago and is now increasingly spreading, as shown by the incoming volume of data on this topic. The enhanced recovery after surgery (ERAS) concept incorporates simple measures of general management, and requires multidisciplinary collaboration from hospital staff as well as the patient and the relatives. Several studies have demonstrated a significant decrease in postoperative complication rate, length of hospital stay and reduced overall cost. The key elements of success are fluid restriction, a functioning epidural and preoperative carbohydrate intake. With the expansion of laparoscopic techniques, ERAS increasingly incorporates laparoscopic patients, especially in colorectal surgery. However, the precise impact of laparoscopy on ERAS is still not clearly defined. Increasing evidence suggests that laparoscopy itself is an additional ERAS item that should be considered as routine where feasible in order to obtain the best surgical outcomes.

The Role of Transnational Elites in shaping the evolving Field of Internet Governance

La gouvernance de l'Internet est une thématique récente dans la politique mondiale. Néanmoins, elle est devenue au fil des années un enjeu économique et politique important. La question a même pris une importance particulière au cours des derniers mois en devenant un sujet d'actualité récurrent. Forte de ce constat, c ette recherche retrace l'histoire de la gouvernance de l'Internet depuis son émergence comme enjeu politique dans les années 1980 jusqu'à la fin du Sommet Mondial sur la Société de l'Information (SMSI) en 2005. Plutôt que de se focaliser sur l'une ou l'autre des institutions impliquées dans la régulation du réseau informatique mondial, cette recherche analyse l'émergence et l'évolution historique d'un espace de luttes rassemblant un nombre croissant d'acteurs différents. Cette évolution est décrite à travers le prisme de la relation dialectique entre élites et non-élites et de la lutte autour de la définition de la gouvernance de l'Internet. Cette thèse explore donc la question de comment les relations au sein des élites de la gouvernance de l'Internet et entre ces élites et les non-élites expliquent l'emergence, l'évolution et la structuration d'un champ relativement autonome de la politique mondiale centré sur la gouvernance de l'Internet. Contre les perspectives dominantes réaliste et libérales, cette recherche s'ancre dans une approche issue de la combinaison des traditions hétérodoxes en économie politique internationale et des apports de la sociologie politique internationale. Celle-ci s'articule autour des concepts de champ, d'élites et d'hégémonie. Le concept de champ, développé par Bourdieu inspire un nombre croissant d'études de la politique mondiale. Il permet à la fois une étude différenciée de la mondialisation et l'émergence d'espaces de lutte et de domination au niveau transnational. La sociologie des élites, elle, permet une approche pragmatique et centrée sur les acteurs des questions de pouvoir dans la mondialisation. Cette recherche utilise plus particulièrement le concept d'élite du pouvoir de Wright Mills pour étudier l'unification d'élites a priori différentes autour de projets communs. Enfin, cette étude reprend le concept néo-gramscien d'hégémonie afin d'étudier à la fois la stabilité relative du pouvoir d'une élite garantie par la dimension consensuelle de la domination, et les germes de changement contenus dans tout ordre international. A travers l'étude des documents produits au cours de la période étudiée et en s'appuyant sur la création de bases de données sur les réseaux d'acteurs, cette étude s'intéresse aux débats qui ont suivi la commercialisation du réseau au début des années 1990 et aux négociations lors du SMSI. La première période a abouti à la création de l'Internet Corporation for Assigned Names and Numbers (ICANN) en 1998. Cette création est le résultat de la recherche d'un consensus entre les discours dominants des années 1990. C'est également le fruit d'une coalition entre intérêts au sein d'une élite du pouvoir de la gouvernance de l'Internet. Cependant, cette institutionnalisation de l'Internet autour de l'ICANN excluait un certain nombre d'acteurs et de discours qui ont depuis tenté de renverser cet ordre. Le SMSI a été le cadre de la remise en cause du mode de gouvernance de l'Internet par les États exclus du système, des universitaires et certaines ONG et organisations internationales. C'est pourquoi le SMSI constitue la seconde période historique étudiée dans cette thèse. La confrontation lors du SMSI a donné lieu à une reconfiguration de l'élite du pouvoir de la gouvernance de l'Internet ainsi qu'à une redéfinition des frontières du champ. Un nouveau projet hégémonique a vu le jour autour d'éléments discursifs tels que le multipartenariat et autour d'insitutions telles que le Forum sur la Gouvernance de l'Internet. Le succès relatif de ce projet a permis une stabilité insitutionnelle inédite depuis la fin du SMSI et une acceptation du discours des élites par un grand nombre d'acteurs du champ. Ce n'est que récemment que cet ordre a été remis en cause par les pouvoirs émergents dans la gouvernance de l'Internet. Cette thèse cherche à contribuer au débat scientifique sur trois plans. Sur le plan théorique, elle contribue à l'essor d'un dialogue entre approches d'économie politique mondiale et de sociologie politique internationale afin d'étudier à la fois les dynamiques structurelles liées au processus de mondialisation et les pratiques localisées des acteurs dans un domaine précis. Elle insiste notamment sur l'apport de les notions de champ et d'élite du pouvoir et sur leur compatibilité avec les anlayses néo-gramsciennes de l'hégémonie. Sur le plan méthodologique, ce dialogue se traduit par une utilisation de méthodes sociologiques telles que l'anlyse de réseaux d'acteurs et de déclarations pour compléter l'analyse qualitative de documents. Enfin, sur le plan empirique, cette recherche offre une perspective originale sur la gouvernance de l'Internet en insistant sur sa dimension historique, en démontrant la fragilité du concept de gouvernance multipartenaire (multistakeholder) et en se focalisant sur les rapports de pouvoir et les liens entre gouvernance de l'Internet et mondialisation. - Internet governance is a recent issue in global politics. However, it gradually became a major political and economic issue. It recently became even more important and now appears regularly in the news. Against this background, this research outlines the history of Internet governance from its emergence as a political issue in the 1980s to the end of the World Summit on the Information Society (WSIS) in 2005. Rather than focusing on one or the other institution involved in Internet governance, this research analyses the emergence and historical evolution of a space of struggle affecting a growing number of different actors. This evolution is described through the analysis of the dialectical relation between elites and non-elites and through the struggle around the definition of Internet governance. The thesis explores the question of how the relations among the elites of Internet governance and between these elites and non-elites explain the emergence, the evolution, and the structuration of a relatively autonomous field of world politics centred around Internet governance. Against dominant realist and liberal perspectives, this research draws upon a cross-fertilisation of heterodox international political economy and international political sociology. This approach focuses on concepts such as field, elites and hegemony. The concept of field, as developed by Bourdieu, is increasingly used in International Relations to build a differentiated analysis of globalisation and to describe the emergence of transnational spaces of struggle and domination. Elite sociology allows for a pragmatic actor-centred analysis of the issue of power in the globalisation process. This research particularly draws on Wright Mill's concept of power elite in order to explore the unification of different elites around shared projects. Finally, this thesis uses the Neo-Gramscian concept of hegemony in order to study both the consensual dimension of domination and the prospect of change contained in any international order. Through the analysis of the documents produced within the analysed period, and through the creation of databases of networks of actors, this research focuses on the debates that followed the commercialisation of the Internet throughout the 1990s and during the WSIS. The first time period led to the creation of the Internet Corporation for Assigned Names and Numbers (ICANN) in 1998. This creation resulted from the consensus-building between the dominant discourses of the time. It also resulted from the coalition of interests among an emerging power elite. However, this institutionalisation of Internet governance around the ICANN excluded a number of actors and discourses that resisted this mode of governance. The WSIS became the institutional framework within which the governance system was questioned by some excluded states, scholars, NGOs and intergovernmental organisations. The confrontation between the power elite and counter-elites during the WSIS triggered a reconfiguration of the power elite as well as a re-definition of the boundaries of the field. A new hegemonic project emerged around discursive elements such as the idea of multistakeholderism and institutional elements such as the Internet Governance Forum. The relative success of the hegemonic project allowed for a certain stability within the field and an acceptance by most non-elites of the new order. It is only recently that this order began to be questioned by the emerging powers of Internet governance. This research provides three main contributions to the scientific debate. On the theoretical level, it contributes to the emergence of a dialogue between International Political Economy and International Political Sociology perspectives in order to analyse both the structural trends of the globalisation process and the located practices of actors in a given issue-area. It notably stresses the contribution of concepts such as field and power elite and their compatibility with a Neo-Gramscian framework to analyse hegemony. On the methodological level, this perspective relies on the use of mixed methods, combining qualitative content analysis with social network analysis of actors and statements. Finally, on the empirical level, this research provides an original perspective on Internet governance. It stresses the historical dimension of current Internet governance arrangements. It also criticise the notion of multistakeholde ism and focuses instead on the power dynamics and the relation between Internet governance and globalisation.

El cáliz 'de San Segundo' entre la realidad y el mito: avatares de un camino de santidad

El cáliz “de San Segundo” atestigua cómo un mismo objeto puede aportar información sobre sus orígenes y sobre su trascendencia en la cultura material de un lugar y época que lo recibieron con posterioridad; desde las manos del platero Andrea Petrucci en la Siena del Trecento hasta su hallazgo en la ciudad de Ávila en 1519 y sus implicaciones en la construcción del mito de San Segundo.

Stage fright: its experience as a problem and coping with it.

PURPOSE AND METHOD: This questionnaire survey of 190 university music students assessed negative feelings of music performance anxiety (MPA) before performing, the experience of stage fright as a problem, and how closely they are associated with each other. The study further investigated whether the experience of stage fright as a problem and negative feelings of MPA predict the coping behavior of the music students. Rarely addressed coping issues were assessed, i.e., self-perceived effectiveness of different coping strategies, knowledge of possible risks and acceptance of substance-based coping strategies, and need for more support.RESULTS: The results show that one-third of the students experienced stage fright as a problem and that this was only moderately correlated with negative feelings of MPA. The experience of stage fright as a problem significantly predicted the frequency of use and the acceptance of medication as a coping strategy. Breathing exercises and self-control techniques were rated as effective as medication. Finally, students expressed a strong need to receive more support (65%) and more information (84%) concerning stage fright.CONCLUSION: Stage fright was experienced as a problem and perceived as having negative career consequences by a considerable percentage of the surveyed students. In addition to a desire for more help and support, the students expressed an openness and willingness to seriously discuss and address the topic of stage fright. This provides a necessary and promising basis for optimal career preparation and, hence, an opportunity to prevent occupational problems in professional musicians. [Authors]

Color of berry and juice of 'Isabel' grape treated with abscisic acid in different ripening stages

Abstract : The objective of this work was to evaluate the effect of (S)-cis-abscisic acid (S-ABA) application at different ripening stages, in increasing phenolic compounds and color of berry and juice of 'Isabel' grape (Vitis labrusca). The evaluated treatments were: control, without S-ABA application; 400 mg L-1S-ABA applied 7 days before veraison (DBV) + 400 mg L-1S-ABA at 35 days after first application (DAFA); 400 mg L-1S-ABA applied at veraison (V) + 400 mg L-1S-ABA at 35 DAFA; and 400 mg L-1S-ABA applied 7 days after veraison (DAV) + 400 mg L-1S-ABA at 35 DAFA. There was no difference among treatments regarding the physical characteristics of berries and clusters, as well as total polyphenols in berry and juice. However, there was an increase in total anthocyanins in berry and juice with S-ABA application. Colorimetric variables indicated the increase in color of berry treated with S-ABA. Juices produced from grapes treated with S-ABA were more appreciated by tasters. The treatments with 400 mg L-1S-ABA applied 7 days before, during, or 7 days after veraison, combined with an additional application 35 days after the first one, increment total anthocyanin concentration and color of berry and juice of 'Isabel' grape, with better juice acceptance, without affecting total polyphenol concentration.

EkyNet-kunnossapitojärjestelmän arkkitehtuuri ja toteutus

Eky-Verkkoon kuuluu Etelä-Karjalan alueelta noin 60 metsäteollisuudelle palveluita tuottavaa pk-yritystä sekä neljä kemiallisen metsäteollisuuden tehdasta. Verkoston jäsenyrityksille on toteutettu web-pohjaiset -tietojärjestelmät EkyNet jaEKMet. EkyNet on tilaajaosapuolen tietojärjestelmä, jonka välityksellä he voivat tiedottaa toimittajaosapuolille mm. tehtaalla tapahtuvista seisokkitöistä. EKMet on Etelä-Karjalan metallitoimialan yritysrekisteri, jonka avulla toimittajayritykset ylläpitävät tietoja resursseistaan. Yhdessä EkyNet ja EKMet toimivat yritysten välisenä tiedonvälityksen työkaluna ja mahdollistavat tarvittavan tiedon saannin verkoston yritysten välillä ajasta ja paikasta riippumatta. Työssä tarkastellaan EkyNet-järjestelmän arkkitehtuuria, sekä EKMetin integroitumista siihen. EkyNetiä on jatkokehitetty ja siihen on toteutettuominaisuuksia, jotka mahdollistavat seisokkiin liittyvien tilausten tunti-ilmoitusten sähköisen hyväksynnän. Lisäksi kuvataan tunti-ilmoitukseen liittyvää problematiikkaa Eky-Verkostossa. Uusiversio EkyNet-järjestelmästä on toteutettu ja se on käyttöönottovaiheessa.

Aligning Technology Innovation Processes for Possible Collaboration

Diplomityön tavoitteena on innovaatioprosessien selventäminen ja yhteensovittaminen radikaalien teknologia innovaatioiden osalta. Prosessien yhteensovittamisen edellytyksenä on teknologia innovaation radikaalisuuden ymmärtäminen. Kohteena on alkuvaiheen innovaatioprosessi jonka aikana virallinen yhteistyö ei vielä ole mandollista. Kehitetyn mallinavulla voidaan arvioida yrityksen kokemaa radikaalisuutta innovaatioprosessin alkuvaiheessa. On tärkeää ymmärtää miten vuorovaikutuksessa olevat yritykset kokevat innovaation radikaalisuuden prosessin alkuvaiheessa. Prosessien eroavaisuudet voidaan sanoa riippuvan yritysten näkökulmasta, koska niiden toiminnot määrittyvät koetun radikaalisuuden mukaan.Yhtäläisenä koettu radikaalisuus luo pohjan avoimelle vuorovaikutukselle ja antaa viitteitä syvemmästä yhteistyöstä tulevaisuudessa. Vertikaalisti sijoittuneiden yritysten prosessien esitetty yhteensovitus perustuu molemminpuoliseen radikaalisuuteen ja sisäisen hyväksynnän vastaavuuteen. Tällöin osapuolet ovat mukana samalla sitoumuksella prosessin jatkumisen ollessa epävarma.

Coping with an HIV infection. A multicenter qualitative survey on HIV positive adolescents' perceptions of their disease, therapeutic adherence and treatment.

HIV-positive adolescents face a number of challenges in dealing with their disease and its treatment. In this qualitative study, twenty-nine HIV-positive adolescents aged 13 to 20 years (22 girls), who live in Switzerland, were asked, in a semi-structured interview (duration of 40-110 minutes), to describe their perceptions and experiences with the disease itself and with therapeutic adherence. While younger adolescents most often thought of their disease as fate, older adolescents usually knew that they had received it through vertical transmission, although the topic appeared to be particularly difficult to discuss for those living with their HIV-positive mothers. Based on their attending physician's assessment, 18 subjects were judged highly adherent, 4 fairly and 7 poorly adherent. High adherence appeared linked with adequate psychological adjustment and effective coping mechanisms, as well as with the discussion and adoption of explicit medication-taking strategies. The setting and organisation of health care teams should allow for ongoing discussions with HIV-positive adolescents that focus on their perceptions of their disease, how they cope with it and with the treatment, and how they could improve their adherence.

Asiakkuusarvojohtaminen ja sitä tukeva asiak-kuusraportointi - Case Neste Markkinointi Oy

Tutkielman tavoitteena on analysoida, miten asiakkuuksien arvoa voidaan johtaa ja miten asiakkuusarvojohtamista voidaan tukea asiakkuusraportoinnin avulla. Teoriaosuudessa analysoidaan asiakaskannattavuuden muodostumista, sekä asiakkuusarvojohtamiseen liittyvää asiakkuusstrategiaa ja raportointiin liittyvää asiakastiedon hallintaa. Empiirinen aineisto pohjautuu case-yrityksen asiakkuusprojektiin, jonka tarkoituksena on tunnistaa erilaiset asiakkuudet ja kehittää niitä siten, että kannattavuus paranisi asiakkaan prosessin ymmärtämisen ja tukemisen kautta. Asiakkuus-raportointi on tärkeä seurannan väline asiakkuusarvojohtamisessa ja se vaatii raportoinnilta luotettavuutta, henkilöstön hyväksyntää käytettävistä kannattavuuslaskentamenetelmistä sekä suhteellisten muutosten ja trendien esittämistä, jotta muutokseen voitaisiin reagoida nopeasti.