Mild cognitive decline. A position statement of the Cognitive Decline Group of the European Innovation Partnership for Active and Healthy Ageing (EIPAHA)

Introduction Mild cognitive impairment (MCI) is a term used to describe a level of decline in cognition which is seen as an intermediate stage between normal ageing and dementia, and which many consider to be a prodromal stage of neurodegeneration that may become dementia. That is, it is perceived as a high risk level of cognitive change. The increasing burden of dementia in our society, but also our increasing understanding of its risk factors and potential interventions, require diligent management of MCI in order to find strategies that produce effective prevention of dementia. Aim To update knowledge regarding mild cognitive impairment, and to bring together and appraise evidence about the main features of clinical interest: definitions, prevalence and stability, risk factors, screening, and management and intervention. Methods Literature review and consensus of expert opinion. Results and conclusion MCI describes a level of impairment in which deteriorating cognitive functions still allow for reasonable independent living, including some compensatory strategies. While there is evidence for some early risk factors, there is still a need to more precisely delineate and distinguish early manifestations of frank dementia from cognitive impairment that is less likely to progress to dementia, and furthermore to develop improved prospective evidence for positive response to intervention. An important limitation derives from the scarcity of studies that take MCI as an endpoint. Strategies for effective management suffer from the same limitation, since most studies have focused on dementia. Behavioural changes may represent the most cost-effective approach.

Majority versus minority influence, message processing and attitude change:the Source-Context-Elaboration Model

This chapter examines the contexts in which people will process more deeply, and therefore be more influenced by, a position that is supported by either a numerical majority or minority. The chapter reviews the major theories of majority and minority influence with reference to which source condition is associated with most message processing (and where relevant, the contexts under which this occurs) and experimental research examining these predictions. The chapter then presents a new theoretical model (the source-context-elaboration model, SCEM) that aims to integrate the disparate research findings. The model specifies the processes underlying majority and minority influence, the contexts under which these processes occur and the consequences for attitudes changed by majority and minority influence. The chapter then describes a series of experiments that address each of the aspects of the theoretical model. Finally, a range of research-related issues are discussed and future issues for the research area as a whole are considered.

Intern pharmacists as change agents to improve the practice of nonprescription medication supply: provision of salbutamol to patients with asthma

BACKGROUND: Earlier work established an evidence practice gap during provision of nonprescription salbutamol (albuterol). Pharmacist interns are hypothesized to be in a position to improve professional practice in the community pharmacy setting. OBJECTIVE: To explore the potential of intern pharmacists to improve the professional practice of community pharmacy staff in the provision of nonprescription salbutamol. METHODS: Intern pharmacists (n = 157) delivered an asthma intervention in 136 pharmacies consisting of an educational activity to pharmacy staff and a health promotion campaign to consumers. Post-intervention, simulated patients presented to 100 intervention and 100 control community pharmacies with a request for salbutamol. The appropriate outcome was medical referral for poor asthma control and correction of poor inhaler technique. Incidence and quantity of patient assessment and counseling provided during the visit were also assessed. Logistic regression was used to determine the predictors of medical referral. RESULTS: A doubling in the rate of medical referral was seen in the intervention group (19% vs 40%; p = 0.001). Assessment of reliever use frequency was the main predictor of medical referral (OR = 22.7; 95% CI 9.06 to 56.9). Correction of poor inhaler technique did not improve; however, a reduction in salbutamol supplied without patient assessment (23% vs 8%; p = 0.009) or counseling (75% vs 48%; p < 0.001) was noted. CONCLUSIONS: A doubling in the rate of medical referral showed a clear improvement in professional practice during the provision of nonprescription salbutamol. The improved patient outcome in the intervention group was due to increased assessment of reliever use frequency. Identification of poor inhaler technique remained near zero in both groups, which suggests that intern pharmacists were able to improve the current practice of community pharmacies yet were unable to establish a new practice behavior. This study provides evidence that intern pharmacists can act as change agents to improve pharmacy practice.

Social media and related technology:drivers of change in managing the contemporary sales force

The selling environment has undergone tremendous transformation over the past 2 decades. Perhaps the greatest change has centered on changes and advancements in technology. The latest dramatic change has been the rapidly increasing use of social media and other related technologies in the business-to-business realm. The sales world began the use of technology through the use of Web 1.0, which was primarily webpage oriented; now we see the world of social media as the paradigm of how firms should implement technology. Although there has been some recent emphasis on how marketing might implement social media into their strategies and how the individual salesperson might implement social media into his or her daily selling routine, no substantive discussion on how social media is affecting the role of the sales manager has appeared in the literature. This article systematically examines how social media is impacting the sales management function and, in fact, may be dramatically revolutionizing the position. To help the marketing and sales organization better understand the changing sales world, we present eight lessons that every sales manager needs to embrace.

Servitization and competitive advantage:the importance of organizational structure and value chain position

Servitization represents a business-model change and organizational transformation from selling goods to selling an integrated combination of goods and services. Competitive advantage is one outcome of this shift. During servitization, companies follow stages to realize services as an opportunity to differentiate from goods and achieve higher customer satisfaction. This study analyzes this transition from base, intermediate, and advanced services by presenting results from 102 senior executives in multinational companies. Our results suggest increasing interest in service-led strategies in manufacturing companies. The results also show that increasing differentiation and high customer satisfaction are fundamental to achieving competitive advantage and superior performance with services. The analysis also indicates the importance of a company’s position in the value chain and the organizational structure it selects to support services in successful servitization.

Engineering education research - the UK perspective at a time of change

Engineering education in the United Kingdom is at the point of embarking upon an interesting journey into uncharted waters. At no point in the past have there been so many drivers for change and so many opportunities for the development of engineering pedagogy. This paper will look at how Engineering Education Research (EER) has developed within the UK and what differentiates it from the many small scale practitioner interventions, perhaps without a clear research question or with little evaluation, which are presented at numerous staff development sessions, workshops and conferences. From this position some examples of current projects will be described, outcomes of funding opportunities will be summarised and the benefits of collaboration with other disciplines illustrated. In this study, I will account for how the design of task structure according to variation theory, as well as the probe-ware technology, make the laws of force and motion visible and learnable and, especially, in the lab studied make Newton's third law visible and learnable. I will also, as a comparison, include data from a mechanics lab that use the same probe-ware technology and deal with the same topics in mechanics, but uses a differently designed task structure. I will argue that the lower achievements on the FMCE-test in this latter case can be attributed to these differences in task structure in the lab instructions. According to my analysis, the necessary pattern of variation is not included in the design. I will also present a microanalysis of 15 hours collected from engineering students' activities in a lab about impulse and collisions based on video recordings of student's activities in a lab about impulse and collisions. The important object of learning in this lab is the development of an understanding of Newton's third law. The approach analysing students interaction using video data is inspired by ethnomethodology and conversation analysis, i.e. I will focus on students practical, contingent and embodied inquiry in the setting of the lab. I argue that my result corroborates variation theory and show this theory can be used as a 'tool' for designing labs as well as for analysing labs and lab instructions. Thus my results have implications outside the domain of this study and have implications for understanding critical features for student learning in labs. Engineering higher education is well used to change. As technology develops the abilities expected by employers of graduates expand, yet our understanding of how to make informed decisions about learning and teaching strategies does not without a conscious effort to do so. With the numerous demands of academic life, we often fail to acknowledge our incomplete understanding of how our students learn within our discipline. The journey facing engineering education in the UK is being driven by two classes of driver. Firstly there are those which we have been working to expand our understanding of, such as retention and employability, and secondly the new challenges such as substantial changes to funding systems allied with an increase in student expectations. Only through continued research can priorities be identified, addressed and a coherent and strong voice for informed change be heard within the wider engineering education community. This new position makes it even more important that through EER we acquire the knowledge and understanding needed to make informed decisions regarding approaches to teaching, curriculum design and measures to promote effective student learning. This then raises the question 'how does EER function within a diverse academic community?' Within an existing community of academics interested in taking meaningful steps towards understanding the ongoing challenges of engineering education a Special Interest Group (SIG) has formed in the UK. The formation of this group has itself been part of the rapidly changing environment through its facilitation by the Higher Education Academy's Engineering Subject Centre, an entity which through the Academy's current restructuring will no longer exist as a discrete Centre dedicated to supporting engineering academics. The aims of this group, the activities it is currently undertaking and how it expects to network and collaborate with the global EER community will be reported in this paper. This will include explanation of how the group has identified barriers to the progress of EER and how it is seeking, through a series of activities, to facilitate recognition and growth of EER both within the UK and with our valued international colleagues.

Online sensorless position estimation for switched reluctance motors using one current sensor

This paper proposes an online sensorless rotor position estimation technique for switched reluctance motors (SRMs) using just one current sensor. It is achieved by first decoupling the excitation current from the bus current. Two phase-shifted pulse width modulation signals are injected into the relevant lower transistors in the asymmetrical half-bridge converter for short intervals during each current fundamental cycle. Analog-to-digital converters are triggered in the pause middles of the dual pulse to separate the bus current for excitation current recognition. Next, the rotor position is estimated from the excitation current, by a current-rise-time method in the current-chopping-control mode in a low-speed operation and a current-gradient method in the voltage-pulse-control mode in a high-speed operation. The proposed scheme requires only a bus current sensor and a minor change to the converter circuit, without a need for individual phase current sensors or additional detection devices, achieving a more compact and cost-effective drive. The performance of the sensorless SRM drive is fully investigated. The simulation and experiments on a 750-W three-phase 12/8-pole SRM are carried out to verify the effectiveness of the proposed scheme.

Stratégiai paradigmaváltás szervezeti verseny(képesség) és az Operations management központi szerepe (Central role of strategic paradigm change, corporate competitiveness and operations management)

Az elmúlt két évtized folyamán a menedzserek megtanultak a megújult szabályok szerint játszani. Tudatosították, hogy a vállalatuk eredményes navigálásához folyamatosan figyelniük és adaptálniuk kell a legújabb módszereket, elméleteket. Jelen tanulmányával a szerző ezt a folyamatot kívánja segíteni, valamint arra az alapvető kérdésre keresi a választ, hogy érdemes-e a rendkívül gyorsan változó világban hosszabb távú célok meghatározásával foglalkozni, és ha igen, akkor mire összpontosítsák a vállalatok erőfeszítéseiket. Milyen részletezettséggel, milyen módon határozzák meg az elképzeléseiket úgy, hogy közben megőrizzék a vállalat flexibilitását, a változások idején nélkülözhetetlen agilitást. A szerző arra vállalkozik, hogy feltárja a stratégiai paradigmaváltás fejlődését, a termelési stratégia, az operations management központi meghatározó szereppé válását, valamint áttekintse a termelési és szolgáltatási rendszervezetés (OM) elveinek, eszközeinek, módszereinek fejlődését, kölcsönhatását, összefüggéseit. _______ Change of paradigm has taken place in strategic planning. Fight for position turned into a fight of movement. Companies strive to achieve individual, not copyable organizational performance, as well as to realize their business strategies by means of value generating, proactive approach. Operative management now placed in the focus of production strategy is becoming the compass, the driving force of leadership. The management of production and service systems has grown into independent scientific disciplines. It yielded such principles, tools and methods which are present as world-renowned blueprints (scientific tools) in the field of maintaining and developing corporate performance. In the present study the author specifies and discusses the tools of operative management as criteria of value generation aiming at quality and cost efficiency. He analyses the backto- back character, interrelationship of quality, TQM (Total Quality Management), TPS (Toyota Production System) and JIT (Just in Time). He examines the effects thereof on corporate performance where significant and strong relationship can be demonstrated in case there is an ability to plan and develop new products. The current new OM (Operations Management) techniques increasingly rely upon the quality of human resources, the permanent improvement of procedures as well as focusing on tight cooperation with suppliers/customers. Supply chain management, core competence management, service management now represent a “new generation” of the OM methods, processes, serving at the same time as basis and starting point for expectable future techniques as well.

Az autóipar szerkezeti átrendeződése – Vállalati stratégiák és a válság hatásai (Structural change in the automotive industry – corporate strategies and the impact of the crisis)

Az írás a globális értékláncok élén álló autóipari cégek világgazdasági válságra adott reakcióit foglalja össze. Megállapítja, hogy a válságnak messze nincs vége: az iparág globális átrendeződése folytatódik. A globális értékláncokba sikeresen betagozódott közép-európai autóipari klaszter ezeknek a folyamatoknak mindmáig nyertese volt. Számolni kell azonban azzal, hogy továbbra is sok a technológiai és a piaci bizonytalanság: az új szereplők belépése, új üzleti modellek elterjedése hosszabb távon felboríthatja a jelenlegi status quo-t, és veszélyeztetheti a hagyományos autóipari befektetőiket munkabér-alapú versenyképességgel megtartani próbáló közép- és kelet-európai országok pozícióit. Az autóipari működő tőkét fogadó közép-kelet-európai országok számára hosszabb távon veszélyt jelenthet az autóipari üzleti modellek átalakulása, a gyártás teljes kiszervezése komplex gyártási szolgáltatást vállaló cégekhez, mivel ez esetben az értéklánc vezető vállalatai bezárhatják a régióban működő gyártóbázisaikat. Az értékláncok élén álló globális cégek „menekülés a minőségbe” stratégiája helyi szinten is követhető, követendő, a működő tőkét fogadó országok versenyképessége kizárólag a helyi leányvállalatok állandó „feljebb lépésével” tartható fenn. ______ This paper summarizes lead firms’ reactions to crisis in global automotive value chains. The paper advances five theses. Author argues that crisis is not over yet, the global restructuring of the industry continues. Actors in the CEE automotive cluster have successfully become integrated into global value chains and have thereby been the winners of past restructuring processes. Nevertheless, technological and market uncertainties prevail: entry of new economic actors and the diffusion of new business models may, in the long run, disrupt the current status quo and jeopardise the world economic position of CEE countries that have been relying solely on their labour cost advantages to sustain direct investment inflows in their automotive industries. In the long run the automotive industries of Central and Eastern European (CEE) economies may become threatened by the transformation of the prevailing automotive business model, the outsourcing of manufacturing and related support activities to complex manufacturing services providers, which could lead to the closure of lead firms’ manufacturing facilities in CEE. Lead firms’ increased focus on high quality high value adding activities strategy can and should be followed by local subsidiaries through a continuous strive for upgrading.

Medium change monitoring using ambient seismic noise and coda wave interferometry: examples from intraplate NE Brazil and the Mid-Atlantic Ridge

This thesis presents and discusses the results of ambient seismic noise correlation for two different environments: intraplate and Mid-Atlantic Ridge. The coda wave interferometry method has also been tested for the intraplate data. Ambient noise correlation is a method that allows to retrieve the structural response between two receivers from ambient noise records, as if one of the station was a virtual source. It has been largely used in seismology to image the subsurface and to monitor structural changes associated mostly with volcanic eruptions and large earthquakes. In the intraplate study, we were able to detect localized structural changes related to a small earthquake swarm, which main event is mR 3.7, North-East of Brazil. We also showed that the 1-bit normalization and spectral whitening result on the loss of waveform details and that the phase auto-correlation, which is amplitude unbiased, seems to be more sensitive and robust for our analysis of a small earthquake swarm. The analysis of 6 months of data using cross-correlations detect clear medium changes soon after the main event while the auto-correlations detect changes essentially after 1 month. It could be explained by fluid pressure redistribution which can be initiated by hydromechanical changes and opened path ways to shallower depth levels due to later occurring earthquakes. In the Mid-Atlantic Ridge study, we investigate structural changes associated with a mb 4.9 earthquake in the region of the Saint Paul transform fault. The data have been recorded by a single broadband seismic station located at less than 200 km from the Mid-Atlantic ridge. The results of the phase auto-correlation for a 5-month period, show a strong co-seismic medium change followed by a relatively fast post-seismic recovery. This medium change is likely related to the damages caused by the earthquake’s ground shaking. The healing process (filling of the new cracks) that lasted 60 days can be decomposed in two phases, a fast recovery (70% in ~30 days) in the early post-seismic stage and a relatively slow recovery later (30% in ~30 days). In the coda wave interferometry study, we monitor temporal changes of the subsurface caused by the small intraplate earthquake swarm mentioned previously. The method was first validated with synthetics data. We were able to detect a change of 2.5% in the source position and a 15% decrease of the scatterers’ amount. Then, from the real data, we observed a rapid decorrelation of the seismic coda after the mR 3.7 seismic event. This indicates a rapid change of the subsurface in the fault’s region induced by the earthquake.

Medium change monitoring using ambient seismic noise and coda wave interferometry: examples from intraplate NE Brazil and the Mid-Atlantic Ridge

This thesis presents and discusses the results of ambient seismic noise correlation for two different environments: intraplate and Mid-Atlantic Ridge. The coda wave interferometry method has also been tested for the intraplate data. Ambient noise correlation is a method that allows to retrieve the structural response between two receivers from ambient noise records, as if one of the station was a virtual source. It has been largely used in seismology to image the subsurface and to monitor structural changes associated mostly with volcanic eruptions and large earthquakes. In the intraplate study, we were able to detect localized structural changes related to a small earthquake swarm, which main event is mR 3.7, North-East of Brazil. We also showed that the 1-bit normalization and spectral whitening result on the loss of waveform details and that the phase auto-correlation, which is amplitude unbiased, seems to be more sensitive and robust for our analysis of a small earthquake swarm. The analysis of 6 months of data using cross-correlations detect clear medium changes soon after the main event while the auto-correlations detect changes essentially after 1 month. It could be explained by fluid pressure redistribution which can be initiated by hydromechanical changes and opened path ways to shallower depth levels due to later occurring earthquakes. In the Mid-Atlantic Ridge study, we investigate structural changes associated with a mb 4.9 earthquake in the region of the Saint Paul transform fault. The data have been recorded by a single broadband seismic station located at less than 200 km from the Mid-Atlantic ridge. The results of the phase auto-correlation for a 5-month period, show a strong co-seismic medium change followed by a relatively fast post-seismic recovery. This medium change is likely related to the damages caused by the earthquake’s ground shaking. The healing process (filling of the new cracks) that lasted 60 days can be decomposed in two phases, a fast recovery (70% in ~30 days) in the early post-seismic stage and a relatively slow recovery later (30% in ~30 days). In the coda wave interferometry study, we monitor temporal changes of the subsurface caused by the small intraplate earthquake swarm mentioned previously. The method was first validated with synthetics data. We were able to detect a change of 2.5% in the source position and a 15% decrease of the scatterers’ amount. Then, from the real data, we observed a rapid decorrelation of the seismic coda after the mR 3.7 seismic event. This indicates a rapid change of the subsurface in the fault’s region induced by the earthquake.

Inequality, the Welfare State, and Demographic Change

This dissertation is a three-part analysis examining how the welfare state in advanced Western democracies has responded to recent demographic changes. Specifically, this dissertation investigates two primary relationships, beginning with the influence of government spending on poverty. I analyze two at-risk populations in particular: immigrants and children of single mothers. Next, attention is turned to the influence of individual and environmental traits on preferences for social spending. I focus specifically on religiosity, religious beliefs and religious identity. I pool data from a number of international macro- and micro-data sources including the Luxembourg Income Study (LIS), International Social Survey Program (ISSP), the World Bank Databank, and the OECD Databank. Analyses highlight the power of the welfare state to reduce poverty, but also the effectiveness of specific areas of spending focused on addressing new social risks. While previous research has touted the strength of the welfare state, my analyses highlight the need to consider new social risks and encourage closer attention to how social position affects preferences for the welfare state.

What's in it for us? A case study research about micro sense making processes through the eyes of front line employees, during culture change implementation

Abstract How employees make sense of change is a very complex process. Recently, academics have neglected to research sense making activities in a micro culture implementation context, through the eyes of front line employees. In contrast to a macro view, a micro perspective limits researchers to only look at an individual, departmental or group level. By doing so, we can zoom in on the details of sense making processes that employees use in their daily work life. A macro (organisational) view is based on the notion that there is a general integrated culture that can be found in all organisational units and departments. It is assumed that culture can be researched by using the entire organisation as one single research entity. This thesis challenges this assumption. In case of planned change it is usually the management community who are in charge of the change intervention. Because of their formal hierarchical position, they have the power to abort or initiate change programs. It is perhaps therefore that researchers tend to be focused on the management community rather than on lower level organisational members, such as front line employees. Apart from the micro view, scholars also neglected to research culture change implementation through the eyes of front line employees. This thesis is an attempt to fill these two gaps that currently exists in academic change management publications. The main research question is therefore: From a micro point of view how do front-line employees make sense of the impact of culture change, during the implementation phase? This thesis starts with a literature review which exposes the two main gaps. The most important outcome of this review is that only 2% of the research articles dealt with culture implementation, through the eyes of front line employees. A conceptual research model is built on the integrated sense making theory of Weber and Manning (2001) and the micro variables of Raelin and Cataldo (2011). These theories emphasize elements of sense making in a daily working context. It is likely that front line employees can identify themselves with research elements such as tasks, skills practices, involvement and behaviour. Front line employees were selected, because as lower level organisational members they are usually the change recipients. They are further away from the change initiating scene (usually the management of an organisation) and form a potential sense making ‘hotspot’ that could provide new academic insights. In order to carry out the primary research, two case organisations were selected in the leisure industry. A participative case study research method was chosen. This meant that the researcher worked in the concerning departments of the case organisations. The goal was to observe and interview front line employees, while they were performing their jobs. The most important advantage of this approach is that the researcher temporarily becomes one with the organisation and is therefore able to acquire both formal and informal narratives that front line employees use during sense making activities. It was found that front line employees make sense of organisational change by using a practical approach. They make sense of the change program by carrying out new tasks, developing new skills and sharing best practices. The most noticeable conclusion was that sense making activities predominantly take place at an individual level in relation to change acceptance. Organisational members tend to create a mental equation in order to weigh the advantages against the disadvantages. They evaluate whether the concerning change program is beneficial to them or not. For future research a sense making scheme model is suggested that is based on two methods: an introspection and an action method.

Compulsory licensing of standard-essential patents and injunctive relief as abuse of dominant position in violation of Article 102 TFEU

When a dominant undertaking holding a standard-essential patent uses its exclusive right to the IP to seek injunctions against those wishing to produce either de jure or de facto standard compliant products, it creates a conflict between the exclusive right to the use of the IP on the one hand and the possible abuse of dominance due to the exclusionary conduct on the other. The aim of the thesis is to focus on the issues concerning abuse of dominance in violation of Article 102 TFEU when the holder of the standard-essential patent seeks an injunction against a would-be licensee. The thesis is mainly based on the most recent ECJ case law in Huawei and the Commission’s recent decisions in Samsung and Motorola. The case law in Europe prior to those decisions was mainly focused on the German case law from Orange Book Standard which provided IP holders great leverage due to the almost automatic granting of injunctions against infringers. The ECJ in Huawei set out the requirements for when a de jure standard-essential patent holder would not be violating Article 102 TFEU when seeking an injunction, requiring that negotiations in good faith must take place prior to the seeking of the injunction and that all offers must comply with FRAND terms, thus limiting the scope of case law derived from Orange Book Standard in Germany. The ECJ chose not to follow all of the reasoning the Commission had laid out in Samsung and Motorola which provided a more licensee-friendly approach on the matter, but rather chose a compromise between the IP holder friendly German case law and the Commission’s decisions. However, the ECJ did not disclose how FRAND terms themselves should be interpreted, but rather left it for the national courts to decide. Furthermore, the thesis strongly argues that Huawei did not change the fact that only vertically integrated IP holders who have made a FRAND declaration are subject to the terms laid out in Huawei, thus leaving non-practicing entities such as patent trolls and entities that have not made a FRAND declaration outside its scope. The resulting conclusion from the thesis is that while the ECJ in Huawei presented new exceptional circumstances for when an IP holder could be abusing its dominant position when it seeks an injunction, it still left many more questions answered, such as the meaning of FRAND and whether deception in giving a FRAND declaration is prohibited under Article 102 TFEU or not.