Patient expectations at a multicultural out-patient clinic in Switzerland.

BACKGROUND: Recognizing patient expectation is considered as an important objective for primary care physicians. A number of studies suggest that failure to identify patient expectations can lead to patient dissatisfaction with care, lack of compliance and inappropriate use of medical resources. It has been suggested that identifying patient expectations in multicultural contexts can be especially challenging. OBJECTIVES: The aim of the study was to compare health care expectations of Swiss and immigrant patients attending the out-patient clinic of a Swiss university hospital and to assess physicians' ability to identify their patients' expectations. METHODS: Over a 3-month period, all patients attending the out-patient clinic at a Swiss university hospital were requested to complete pre-consultation surveys. Their physicians were requested to complete post-consultation surveys. Outcome measures were patients' self-rated health, resort to prior home treatment, patients' expectations of the consultation, physicians' perception of their patients' expectations and agreement between patients and physicians. RESULTS: We analysed 343 questionnaires completed by patients prior to their consultation (> 50% immigrants) and 333 questionnaires completed by their physicians after the consultation. Most expectations were shared by all patients. Physicians had inaccurate perceptions of their patients' expectations, regardless of patients' origin. CONCLUSIONS: Our study found no evidence that immigrant patients' expectations differed from those of Swiss patients, nor that physicians had more difficulty identifying expectations of immigrant patients. However, physicians in our study were generally poor at identifying patients' expectations, and therefore inter-group differences may be difficult to detect. Our results point to the need to strengthen physicians' general communication skills which should then serve as a foundation for more specific, cross-cultural communication training.

Rationale and design of a randomized, double-blind, parallel-group study of terutroban 30 mg/day versus aspirin 100 mg/day in stroke patients: the prevention of cerebrovascular and cardiovascular events of ischemic origin with terutroban in patients with a history of ischemic stroke or transient ischemic attack (PERFORM) study.

BACKGROUND: Ischemic stroke is the leading cause of mortality worldwide and a major contributor to neurological disability and dementia. Terutroban is a specific TP receptor antagonist with antithrombotic, antivasoconstrictive, and antiatherosclerotic properties, which may be of interest for the secondary prevention of ischemic stroke. This article describes the rationale and design of the Prevention of cerebrovascular and cardiovascular Events of ischemic origin with teRutroban in patients with a history oF ischemic strOke or tRansient ischeMic Attack (PERFORM) Study, which aims to demonstrate the superiority of the efficacy of terutroban versus aspirin in secondary prevention of cerebrovascular and cardiovascular events. METHODS AND RESULTS: The PERFORM Study is a multicenter, randomized, double-blind, parallel-group study being carried out in 802 centers in 46 countries. The study population includes patients aged > or =55 years, having suffered an ischemic stroke (< or =3 months) or a transient ischemic attack (< or =8 days). Participants are randomly allocated to terutroban (30 mg/day) or aspirin (100 mg/day). The primary efficacy endpoint is a composite of ischemic stroke (fatal or nonfatal), myocardial infarction (fatal or nonfatal), or other vascular death (excluding hemorrhagic death of any origin). Safety is being evaluated by assessing hemorrhagic events. Follow-up is expected to last for 2-4 years. Assuming a relative risk reduction of 13%, the expected number of primary events is 2,340. To obtain statistical power of 90%, this requires inclusion of at least 18,000 patients in this event-driven trial. The first patient was randomized in February 2006. CONCLUSIONS: The PERFORM Study will explore the benefits and safety of terutroban in secondary cardiovascular prevention after a cerebral ischemic event.

Technology selection and group decision support systems: Case studies on supporting strategic technology selection processes

The objective of the dissertation is to increase understanding and knowledge in the field where group decision support system (GDSS) and technology selection research overlap in the strategic sense. The purpose is to develop pragmatic, unique and competent management practices and processes for strategic technology assessment and selection from the whole company's point of view. The combination of the GDSS and technology selection is approached from the points of view of the core competence concept, the lead user -method, and different technology types. In this research the aim is to find out how the GDSS contributes to the technology selection process, what aspects should be considered when selecting technologies to be developed or acquired, and what advantages and restrictions the GDSS has in the selection processes. These research objectives are discussed on the basis of experiences and findings in real life selection meetings. The research has been mainly carried outwith constructive, case study research methods. The study contributes novel ideas to the present knowledge and prior literature on the GDSS and technology selection arena. Academic and pragmatic research has been conducted in four areas: 1) the potential benefits of the group support system with the lead user -method,where the need assessment process is positioned as information gathering for the selection of wireless technology development projects; 2) integrated technology selection and core competencies management processes both in theory and in practice; 3) potential benefits of the group decision support system in the technology selection processes of different technology types; and 4) linkages between technology selection and R&D project selection in innovative product development networks. New type of knowledge and understanding has been created on the practical utilization of the GDSS in technology selection decisions. The study demonstrates that technology selection requires close cooperation between differentdepartments, functions, and strategic business units in order to gather the best knowledge for the decision making. The GDSS is proved to be an effective way to promote communication and co-operation between the selectors. The constructs developed in this study have been tested in many industry fields, for example in information and communication, forest, telecommunication, metal, software, and miscellaneous industries, as well as in non-profit organizations. The pragmatic results in these organizations are some of the most relevant proofs that confirm the scientific contribution of the study, according to the principles of the constructive research approach.

Extreme-value distributions and renormalization group

In the classical theorems of extreme value theory the limits of suitably rescaled maxima of sequences of independent, identically distributed random variables are studied. The vast majority of the literature on the subject deals with affine normalization. We argue that more general normalizations are natural from a mathematical and physical point of view and work them out. The problem is approached using the language of renormalization-group transformations in the space of probability densities. The limit distributions are fixed points of the transformation and the study of its differential around them allows a local analysis of the domains of attraction and the computation of finite-size corrections.

ASP-malli ja sen alustavien kohdesegmenttien määrittely. Case: Novo Group Oyj

Tutkielman tavoitteena oli selvittää ASP-, eli sovellusvuokrausmallin erityis-piirteitä sekä määrittää alustavat kohdesegmentit toiminnan-, talouden- ja henkilöstönohjausjärjestelmille ASP-ratkaisuna. Työ on kaksiosainen. Tutkimuksen teoreettisessa osassa keskitytään segmentoinnin teorioihin, tietojärjestelmien ulkoistamisen motiiveihin sekä etuihin ja haittoihin sekä ASP-malliin kokonaisuudessaan. Tutkimuksen empiiristä osuutta varten suoritettiin kvalitatiivinen tutkimus, joka koostui 20 haastattelusta 18 eri organisaatiossa. Haastateltavat olivat pääasiassa asiakasyritysten tietohallintopäällikköjä. Alustavat kohdesegmentit muodostettiin teoreettisessa osassa esitettyjen ASP-mallin erityispiirteiden sekä haastattelututkimuksesta saadun informaation perusteella. ASP on uusi malli tietojärjestelmien hankintaan. ASP on käsitteenä vain noin kolme vuotta vanha tutkielman tekohetkellä. Kyseessä on malli, jolle tutkimuslaitokset ovat tehneet lupaavia kasvuennusteita IT-markkinoilla. Markkinoiden kasvu ei ole kuitenkaan ollut ennusteiden mukaista. ASP-ratkaisuna hankittu tietojärjestelmä on kokonaisvaltainen ulkoistusmalli. Kaikki mahdollinen ASP-ratkaisuna hankittavaan järjestelmään tai sovellukseen liittyvä ulkoistetaan palveluntarjoajalle. Tutkimuksessa selvisi, että kiinnostusta mallia kohtaan on olemassa. Mallin edut nähdään suurempina kuin haitat. ASP-ratkaisun käyttöönotolla asiakasyritykselle mahdollistuu resurssien kohdentaminen ydinliiketoimintaan.

Singling out individual inventors from patent data

An increasing number of studies in recent years have sought to identify individual inventors from patent data. A variety of heuristics have been proposed for using the names and other information disclosed in patent documents to establish who is who in patents. This paper contributes to this literature by describing a methodology for identifying inventors using patents applied to the European Patent Office, EPO hereafter. As in much of this literature, we basically follow a threestep procedure : 1- the parsing stage, aimed at reducing the noise in the inventor’s name and other fields of the patent; 2- the matching stage, where name matching algorithms are used to group similar names; and 3- the filtering stage, where additional information and various scoring schemes are used to filter out these similarlynamed inventors. The paper presents the results obtained by using the algorithms with the set of European inventors applying to the EPO over a long period of time.

Searching for consensus in ahp-group decision making. A bayesian perspective

This paper sets out to identify the initial positions of the different decisionmakers who intervene in a group decision making process with a reducednumber of actors, and to establish possible consensus paths between theseactors. As a methodological support, it employs one of the most widely-knownmulticriteria decision techniques, namely, the Analytic Hierarchy Process(AHP). Assuming that the judgements elicited by the decision makers follow theso-called multiplicative model (Crawford and Williams, 1985; Altuzarra et al.,1997; Laininen and Hämäläinen, 2003) with log-normal errors and unknownvariance, a Bayesian approach is used in the estimation of the relative prioritiesof the alternatives being compared. These priorities, estimated by way of themedian of the posterior distribution and normalised in a distributive manner(priorities add up to one), are a clear example of compositional data that will beused in the search for consensus between the actors involved in the resolution ofthe problem through the use of Multidimensional Scaling tools

PhD Students’ Research Group Networks: a Qualitative Approach

This article examines the networks within the research groups where Spanish PhD students are pursuing their doctorate. Capó et al. (2007) used quantitative data to predict PhD students’ publishing performance from their background, attitudes, supervisors’ performance and research group networks. Variables related to the research group network had a negligible explanatory power on student performance once the remaining variables had been accounted for. In this article, a qualitative follow up of the same students is carried out using extreme case sampling and indepth interviews. The qualitative research shows networking as important for students. Out of the 115 aspects that students mention in the interviews as relevant to publishing in the qualitative research, 92 have to do with their supervisors, their research group or their network as a whole. Similarly, out of the 50 hindrances mentioned, 20 have to do with the networks or relations. The most commonly mentioned network-related topics are research group members pushing PhD students to publish, meeting researchers outside the research group, existence of other PhD students in the group, help with the PhD from group members, supervisor’s interest in the thesis, the possibility of discussing with experts on the PhD’s topic and frequent contact with the supervisor and research group members. Some of these characteristics were not, however, measured in the conventional quantitative social network survey

Spectroscopic analysis of C80 doping with group III and group V elements using semiempirical PM3 molecular modelling technique

Semiempirical calculations at the level of PM3 of theory were carried out to study the structural and electronic properties of C80 and some of its doped derivatives with the elements of group III and V at the level of PM3 of theory. We have selected these elements to be substituted in the fullerene-C80 cage in order to show the effect of such structural change on the electronic properties of the molecules studied. The theoretical IR spectra, some of physical and chemical properties of the molecules studied are obtained and discussed.

Evaluation of group electronegativities and hardness (softness) of group 14 elements and containing functional groups through density functional theory and correlation with NMR spectra data

Quantum Chemical calculations for group 14 elements of Periodic Table (C, Si, Ge, Sn, Pb) and their functional groups have been carried out using Density Functional Theory (DFT) based reactivity descriptors such as group electronegativities, hardness and softness. DFT calculations were performed for a large series of tetracoordinated Sn compounds of the CH3SnRR'X type, where X is a halogen and R and R' are alkyl, halogenated alkyl, alkoxy, or alkyl thio groups. The results were interpreted in terms of calculated electronegativity and hardness of the SnRR'X groups, applying a methodology previously developed by Geerlings and coworkers (J. Phys. Chem. 1993, 97, 1826). These calculations allowed to see the regularities concerning the influence of the nature of organic groups RR' and inorganic group X on electronegativities and hardness of the SnRR'X groups; in this case, it was found a very good correlation between the electronegativity of the fragment and experimental 119Sn chemical shifts, a property that sensitively reflects the change in the valence electronic structure of molecules. This work was complemented with the study of some compounds of the EX and ER types, where E= C, Si, Ge, Sn and R= CH3, H, which was performed to study the influence that the central atom has on the electronegativity and hardness of molecules, or whether these properties are mainly affected for the type of ligand bound to the central atom. All these calculations were performed using the B3PW91 functional together with the 6-311++G** basis set level for H, C, Si, Ge, F, Cl and Br atoms and the 3-21G for Sn and I atoms.

Monitoring and molecular characterization of group Drotavirus in Brazilian poultry farms

Abstract: Rotaviruses are etiological agents of diarrhea both in humans and in several animal species. Data on avian Group D rotaviruses (RVD) are scarce, especially in Brazil. We detected RVD in 4 pools of intestinal contents of broilers, layer and broiler breeders out of a total of 111 pools from 8 Brazilian states, representing an occurrence of 3.6%, by a specific RVD RT-PCR targeting the VP6 gene. Phylogenetic tree confirmed that the Brazilian strains belong to group D and 3 of the sequences were identical in terms of amino acid whereas one showed 99.5% identity with the others. The sequences described in this study are similar to other sequences previously detected in Brazil, confirming the conserved nature of the VP6 protein.

A mathematical framework for group analysis of von Willebrand factor multimeric composition following luminography

The objective of the present study was to establish a method for quantitative analysis of von Willebrand factor (vWF) multimeric composition using a mathematical framework based on curve fitting. Plasma vWF multimers from 15 healthy subjects and 13 patients with advanced pulmonary vascular disease were analyzed by Western immunoblotting followed by luminography. Quantitative analysis of luminographs was carried out by calculating the relative densities of low, intermediate and high molecular weight fractions using laser densitometry. For each densitometric peak (representing a given fraction of vWF multimers) a mean area value was obtained using data from all group subjects (patients and normal individuals) and plotted against the distance between the peak and IgM (950 kDa). Curves were constructed for each group using nonlinear fitting. Results indicated that highly accurate curves could be obtained for healthy controls and patients, with respective coefficients of determination (r²) of 0.9898 and 0.9778. Differences were observed between patients and normal subjects regarding curve shape, coefficients and the region of highest protein concentration. We conclude that the method provides accurate quantitative information on the composition of vWF multimers and may be useful for comparisons between groups and possibly treatments.

Effect of aging on carotid artery stiffness and baroreflex sensitivity during head-out water immersion in man

To examine the possible age-related blood pressure (BP) deregulation in response to central hypervolemia, we measured spontaneous baroreflex sensitivity (SBRS), carotid arterial compliance (CC), and R-R interval coefficient of variation (RRICV) during basal and thermoneutral resting head-out-of-water immersion (HOWI) in 7 young (YG = 24.0 ± 0.8 years) and 6 middle-aged/older (OL = 59.3 ± 1.3 years) healthy men. Compared with basal conditions (YG = 19.6 ± 4.0 vs OL = 6.1 ± 1.5 ms/mmHg, P < 0.05), SBRS remained higher in YG than OL during rest HOWI (YG = 23.6 ± 6.6 vs OL = 9.3 ± 2.1 ms/mmHg, P < 0.05). The RRICV was significantly different between groups (YG = 6.5 ± 1.4 vs OL = 2.8 ± 0.4%, P < 0.05) under HOWI. The OL group had no increase in CC, but a significant increase in systolic BP (basal = 115.3 ± 4.4 vs water = 129.3 ± 5.3 mmHg, P < 0.05) under HOWI. In contrast, the YG group had a significant increase in CC (basal = 0.16 ± 0.01 vs water = 0.17 ± 0.02 mm²/mmHg, P < 0.05) with no changes in systolic BP. SBRS was positively related to CC (r = 0.58, P < 0.05 for basal vs r = 0.62, P < 0.05 for water). Our data suggest that age-related vagal dysfunction and reduced CC may be associated with SBRS differences between YG and OL groups, and with BP elevation during HOWI in healthy older men.

Performance improvement in mediterranean operations using risk management analysis : Case study of Containerships Group Ltd

Emerging markets of Northern Africa and Turkey provide growth opportunities for logistics service companies in the middle of low growth environment of European Union. The purpose of this research is to explore and analyze the risk factors in container shipping industry and third party logistics (3PL) services. The research empirically examined the risk factors, which are related within the interaction between these two parties in emerging markets of Mediterranean area. The previous studies have provided a valuable insight into the operational risks faced by container shipping industries. However, most of these studies have focused on one or several operational risk factors from a single point of view, and no studies have inclusively examined the possible operational risks faced in the container shipping industry from dual perspective of 3PL provider and its customers. A questionnaire has been deployed to collect related data; and the impacts of the risks were then be assessed and ranked using the method of risk mapping. Respondents were located in Turkey, Algeria, Tunisia, and Libya. Research presents the most important risk factors identified, and compares them between 3PL provider and its customers. The research also provide some risk mitigation strategies for the key risk factors, and tried to figure out a common risk picture, which guides the managers in both sides to have a better decisions and as a result, improve the performance of the container shipping operations. Challenge during project execution time was that customers identified vast amount of more risks than what was the case with logistics service operator.