Snoring and sleep apnea in children

Snoring is a primary and major clinical symptom of upper airway obstruction during sleep. Sleep-disordered breathing ranges from primary snoring to significant partial upper airway obstruction, and obstructive sleep apnea. Adult snoring and obstructive sleep apnea have been extensively studied, whereas less is known about these disorders in children. Snoring and more severe obstructive sleep apnea have been shown to have a harmful effect on the neurobehavioral development of children, but the mechanisms of this effect remains unknown. Furthermore, the correlation of this effect to objective sleep study parameters remains poor. This study evaluated the prevalence of snoring in preschool-aged children in Finland. Host and environmental risk factors, and neurobehavioral and neurocognitive symptoms of children suffering from snoring or obstructive sleep apnea were also investigated. The feasibility of acoustic rhinometry in young children was assessed. The prevalence and risk factors of snoring (I) were evaluated by a questionnaire. The random sample included 2100 children aged 1-6 years living in Helsinki. All 3- to 6-year-old children whose parents reported their child to snore always, often, or sometimes were categorized as snorers, and invited to participate to the clinical study (II-IV). Non-snoring children whose parents were willing to participate in the clinical study were invited to serve as controls. Children underwent a clinical ear-nose-throat examination. Emotional, behavioral, and cognitive performances were evaluated by Child Behavioral Checklist (CBCL), Wechsler Preschool and Primary Scale of Intelligence (WPPSI-R) and NEPSY-A Developmental Neuropsychological Assessment (NEPSY). Nasal volume was measured by acoustic rhinometry, and nasal resistance by rhinomanometry. Lateral and posteroanterior cephalometry were performed. A standard overnight ambulatory polysomnography was performed in the home environment. Twenty-six healthy children were tested in order to assess the feasibility of acoustic rhinometry in young children (V). Snoring was common in children; 6.3% of children snored always or often, whereas 81.3% snored never or occasionally. No differences were apparent between snorers and non-snorers regarding age, or gender. Pediatric snoring was associated with recurrent upper respiratory infections, otitis media, and allergic rhinitis. Exposure to parental tobacco smoke, especially maternal smoking, was more common among snorers. Rhinitis was more common among children who exposured to tobacco smoke. Overnight polysomnography (PSG) was performed on 87 children; 74% showed no signs of significant upper airway obstruction during sleep. Three children had obstructive apnea/hypopnea index (OAHI) greater than 5/h. Age, gender, or a previous adenoidectomy or tonsillectomy did not correlate with OAHI, whereas tonsillar size did correlate with OAHI. Relative body weight and obesity correlated with none of the PSG parameters. In cephalometry, no clear differences or correlations were found in PSG parameters or between snorers and non-snorers. No correlations were observed between acoustic rhinometry, rhinomanometry, and PSG parameters. Psychiatric symptoms were more frequent in the snoring group than in the nonsnoring group. In particular, anxious and depressed symptoms were more prevalent in the snoring group. Snoring children frequently scored lower in language functions. However, PSG parameters correlated poorly with neurocognitive test results in these children. This study and previous studies indicate that snoring without episodes of obstructive apnea or SpO2 desaturations may cause impairment in behavioral and neurocognitive functions. The mechanism of action remains unknown. Exposure to parental tobacco smoke is more common among snorers than non-snorers, emphasizing the importance of a smoke-free environment. Children tolerated acoustic rhinometry measurements well.

Tietokone ikäihmisen arjessa

The aged people in the target group of my study belong to generation, which has experienced the shift from agricultural society via industrial society up to the society which has been described as information society. They have grown up concurrently with the technological development, but during the recent years the technological development has accelerated. One can say that the older the target study group has come the more information technological skills they need to possess to be equal actors in our society. However, especially in case of aged people the learning and maintaining of skills in information technology has mainly been left dependent on their personal motivation. The purpose of this report is to study the use of computers in the life of the aged people. The report studies the will and ability of the aged people to learn the skill of using computers, and the new possibilities which this brings into their lives. The study questions are the following: 1) Why the aged people start to use computers? 2) How the aged people benefit information technology in their own life? 3) How computers have extended the environment of the aged people? 4) What kind of problems the aged people have experienced in use of computers? The research material consists of group interviews and individual interviews (total of 23 people). The interview material has been collected among the participants on information technology courses of the Senior University of Helsinki University during years 2004-2005. The research method used is theme interviewing. In addition, the material of opinions about information technology of people born in decades of 1920 and 1930, gathered as part of the Ikihyvä Päijät-Häme 2002 -research has been used. On basis of this research one can say that the aged people do have motivation to study the use of computers, although many interviewees commented that they also have met problems in use of computers. The motivation has grown also because the fear that without the skills to use computers they could drift into outsiders of the society, whereas instead as skilled computer users they felt to be equal citizens compared with the younger age groups, and that they can maintain their independence and autonomy. Especially, the independent use of banking routines over the Internet and use of emails seem to give them a position as modern actors. Many interview statements also underline that computers will bring both joy and benefit to the users. Studying the use of computers is a new and interesting hobby, which can fill the hole left in the life after leaving the working life. Using skills of text processing and processing of pictures one can, for example, record the traditional knowledge of the family and ancestry to the younger generations, and write articles or even books on the professional area of ones own. Single people emphasize that computers can even act as companionship substitutes. One can use Internet for virtual traveling, which provides a new dimension in use of computers. Internet can also be used to maintain family relationships, especially between grandparents and remote grandchildren. Typical problems in use of computers appeared to be that reaching the right professional helpdesk advisers of the service providers is difficult and requires lots of time and patience. However, the interviewees were not willing to give up their computers, because they had already used to these. Keywords: digital divide, aging, Internet, usability, motivation, information technology, information society.

Strategic Sales Process Adaptation: Relationship Orientation of the Sales Process in a Business-to-Business Context

Although previous research has recognised adaptation as a central aspect in relationships, the adaptation of the sales process to the buying process has not been studied. Furthermore, the linking of relationship orientation as mindset with adaptation as a strategy and forming the means has not been elaborated upon in previous research. Adaptation in the context of relationships has mostly been studied in relationship marketing. In sales and sales management research, adaptation has been studied with reference to personal selling. This study focuses on adaptation of the sales process to strategically match it to the buyer’s mindset and buying process. The purpose of this study is to develop a framework for strategic adaptation of the seller’s sales process to match the buyer’s buying process in a business-to-business context to make sales processes more relationship oriented. In order to arrive at a holistic view of adaptation of the sales process during relationship initiation, both the seller and buyer are included in an extensive case analysed in the study. However, the selected perspective is primarily that of the seller, and the level focused on is that of the sales process. The epistemological perspective adopted is constructivism. The study is a qualitative one applying a retrospective case study, where the main sources of information are in-depth semi-structured interviews with key informants representing the counterparts at the seller and the buyer in the software development and telecommunications industries. The main theoretical contributions of this research involve targeting a new area in the crossroads of relationship marketing, sales and sales management, and buying and purchasing by studying adaptation in a business-to-business context from a new perspective. Primarily, this study contributes to research in sales and sales management with reference to relationship orientation and strategic sales process adaptation. This research fills three research gaps. Firstly, linking the relationship orientation mindset with adaptation as strategy. Secondly, extending adaptation in sales from adaptation in selling to strategic adaptation of the sales process. Thirdly, extending adaptation to include facilitation of adaptation. The approach applied in the study, systematic combining, is characterised by continuously moving back and forth between theory and empirical data. The framework that emerges, in which linking mindset with strategy with mindset and means forms a central aspect, includes three layers: purchasing portfolio, seller-buyer relationship orientation, and strategic sales process adaptation. Linking the three layers enables an analysis of where sales process adaptation can make a contribution. Furthermore, implications for managerial use are demonstrated, for example how sellers can avoid the ‘trap’ of ad-hoc adaptation. This includes involving the company, embracing the buyer’s purchasing portfolio, understanding the current position that the seller has in this portfolio, and possibly educating the buyer about advantages of adopting a relationship-oriented approach.

Incentive mechanism to control customer buy-down behaviour

Airlines have successfully practiced revenue management over the past four decades and enhanced their revenue. Most of the traditional models that are applied assume that customers buying a high-fare class ticket will not purchase a low-fare class ticket even if it is available. This is not a very realistic assumption and has led to revenue leakage due to customers exhibiting buy-down behaviour. This paper aims at devising a suitable incentive mechanism that would incite the customer to reveal his nature. This helps in reducing revenue leakage. We show that the proposed incentive mechanism is profitable to both the buyer and seller and hence ensures the buyers participation in the mechanism. Journal of the Operational Research Society (2011) 62, 1566-1573. doi:10.1057/jors.2010.57 Published online 11 August 2010

A Coalition game model for spectrum pooling in wireless data access networks

We consider a setting in which several operators offer downlink wireless data access services in a certain geographical region. Each operator deploys several base stations or access points, and registers some subscribers. In such a situation, if operators pool their infrastructure, and permit the possibility of subscribers being served by any of the cooperating operators, then there can be overall better user satisfaction, and increased operator revenue. We use coalitional game theory to investigate such resource pooling and cooperation between operators.We use utility functions to model user satisfaction, and show that the resulting coalitional game has the property that if all operators cooperate (i.e., form a grand coalition) then there is an operating point that maximizes the sum utility over the operators while providing the operators revenues such that no subset of operators has an incentive to break away from the coalition. We investigate whether such operating points can result in utility unfairness between users of the various operators. We also study other revenue sharing concepts, namely, the nucleolus and the Shapely value. Such investigations throw light on criteria for operators to accept or reject subscribers, based on the service level agreements proposed by them. We also investigate the situation in which only certain subsets of operators may be willing to cooperate.

Trade determination in multi-attribute exchanges

Electronic exchanges are double-sided marketplaces that allow multiple buyers to trade with multiple sellers, with aggregation of demand and supply across the bids to maximize the revenue in the market. Two important issues in the design of exchanges are (1) trade determination (determining the number of goods traded between any buyer-seller pair) and (2) pricing. In this paper we address the trade determination issue for one-shot, multi-attribute exchanges that trade multiple units of the same good. The bids are configurable with separable additive price functions over the attributes and each function is continuous and piecewise linear. We model trade determination as mixed integer programming problems for different possible bid structures and show that even in two-attribute exchanges, trade determination is NP-hard for certain bid structures. We also make some observations on the pricing issues that are closely related to the mixed integer formulations.

Reinforcement learning applications in dynamic pricing of retail markets

In this paper, we investigate the use of reinforcement learning (RL) techniques to the problem of determining dynamic prices in an electronic retail market. As representative models, we consider a single seller market and a two seller market, and formulate the dynamic pricing problem in a setting that easily generalizes to markets with more than two sellers. We first formulate the single seller dynamic pricing problem in the RL framework and solve the problem using the Q-learning algorithm through simulation. Next we model the two seller dynamic pricing problem as a Markovian game and formulate the problem in the RL framework. We solve this problem using actor-critic algorithms through simulation. We believe our approach to solving these problems is a promising way of setting dynamic prices in multi-agent environments. We illustrate the methodology with two illustrative examples of typical retail markets.

Optimal incentive timing strategies for product marketing on social networks

We consider the problem of devising incentive strategies for viral marketing of a product. In particular, we assume that the seller can influence penetration of the product by offering two incentive programs: a) direct incentives to potential buyers (influence) and b) referral rewards for customers who influence potential buyers to make the purchase (exploit connections). The problem is to determine the optimal timing of these programs over a finite time horizon. In contrast to algorithmic perspective popular in the literature, we take a mean-field approach and formulate the problem as a continuous-time deterministic optimal control problem. We show that the optimal strategy for the seller has a simple structure and can take both forms, namely, influence-and-exploit and exploit-and-influence. We also show that in some cases it may optimal for the seller to deploy incentive programs mostly for low degree nodes. We support our theoretical results through numerical studies and provide practical insights by analyzing various scenarios.

Voluntades anticipadas, su valor legal

Resumen: El autor analiza el contenido de las denominadas directivas previas o testamento vital, que una persona puede instrumentar a efectos de instruir a los médicos que en el futuro la atiendan en el supuesto de no poder en ese momento expresar su voluntad, relacionadas con los tratamientos que está dispuesta a que le sean aplicados. Se hace referencia al alcance, los inconvenientes y peligros que traen aparejadas dichas directivas, su tiempo de validez y la situación actual en otros países y en el nuestro, así como una escueta reseña de dos sentencias dictadas en el país al respecto.

Turnout Intention and Social Networks

How can networking affect the turnout in an election? We present a simple model to explain turnout as a result of a dynamic process of formation of the intention to vote within Erdös-Renyi random networks. Citizens have fixed preferences for one of two parties and are embedded in a given social network. They decide whether or not to vote on the basis of the attitude of their immediate contacts. They may simply follow the behavior of the majority (followers) or make an adaptive local calculus of voting (Downsian behavior). So they either have the intention of voting when the majority of their neighbors are willing to vote too, or they vote when they perceive in their social neighborhood that elections are "close". We study the long run average turnout, interpreted as the actual turnout observed in an election. Depending on the combination of values of the two key parameters, the average connectivity and the probability of behaving as a follower or in a Downsian fashion, the system exhibits monostability (zero turnout), bistability (zero turnout and either moderate or high turnout) or tristability (zero, moderate and high turnout). This means, in particular, that for a wide range of values of both parameters, we obtain realistic turnout rates, i.e. between 50% and 90%.

Non-Stationary Demand in a Durable Goods Monopoly

In a context where demand for the services of a durable good changes over time, and this change may be uncertain, the paper shows that social welfare may be higher when the monopolist seller can commit to any future price level she wishes than when she cannot. Moreover, the equilibrium under a monopolist with commitment power may Pareto-dominate the equilibrium under a monopolist without commitment ability. These results affect the desired regulation of a durable goods monopolist in this context.

Aplicación de la Lógica Dominante del servicio (LDS) en el sector turístico: el marketing interno como antecedente de la cultura de co-creación de innovaciones con clientes y empleados

[ES] Este trabajo trata de profundizar en la comprensión del concepto de marketing interno (MI), considerado como un recurso operante desde la óptica de la Lógica Dominante del Servicio (LDS), así como en su influencia en la obtención de resultados empresariales superiores a los de la competencia. Para ello, se examina el efecto del MI en la predisposición de las empresas analizadas a que sus clientes y empleados de primera línea participen en el desarrollo de innovaciones de servicio, ampliando de este modo, de acuerdo con la LDS, las oportunidades de co-creación de valor disponibles para las organizaciones. Para contrastar las hipótesis planteadas se aplica un análisis de ecuaciones estructurales a la información facilitada por los gerentes de 240 hoteles de una muestra de ámbito nacional.

Relevance of the programmes of the federal fisheries schools to Nigeria's fishing industry

Nigeria's three federal fisheries schools are administered by three autonomous research institutes located in Lagos, New Bussa, and Maiduguri. The schools were established at different periods to train the required manpower for Nigeria's fishing industry which has remained predominantly artisanal since its inception in 1942 as a Second World War exigency. Despite the establishment of the schools, the industry's manpower is still being dominated by non-nationals especially in the capture fisheries sub-sector. The common features of the schools include the apparent insensitivity of their programmes to the industry's dynamic manpower needs; the absence of coordination of their programmes by a national body which would have ensured that the schools are able to communicate with one another and are willing to act and share a purpose. The need and the methodology for a change of emphasis from the on-going training of extension agents and officers to that of fishing operatives and technicians to enable Nigeria effectively harness her local fish resources towards self-sufficiency is highlighted.

Essays on economics networks

This thesis belongs to the growing field of economic networks. In particular, we develop three essays in which we study the problem of bargaining, discrete choice representation, and pricing in the context of networked markets. Despite analyzing very different problems, the three essays share the common feature of making use of a network representation to describe the market of interest.

In Chapter 1 we present an analysis of bargaining in networked markets. We make two contributions. First, we characterize market equilibria in a bargaining model, and find that players' equilibrium payoffs coincide with their degree of centrality in the network, as measured by Bonacich's centrality measure. This characterization allows us to map, in a simple way, network structures into market equilibrium outcomes, so that payoffs dispersion in networked markets is driven by players' network positions. Second, we show that the market equilibrium for our model converges to the so called eigenvector centrality measure. We show that the economic condition for reaching convergence is that the players' discount factor goes to one. In particular, we show how the discount factor, the matching technology, and the network structure interact in a very particular way in order to see the eigenvector centrality as the limiting case of our market equilibrium.

We point out that the eigenvector approach is a way of finding the most central or relevant players in terms of the “global” structure of the network, and to pay less attention to patterns that are more “local”. Mathematically, the eigenvector centrality captures the relevance of players in the bargaining process, using the eigenvector associated to the largest eigenvalue of the adjacency matrix of a given network. Thus our result may be viewed as an economic justification of the eigenvector approach in the context of bargaining in networked markets.

As an application, we analyze the special case of seller-buyer networks, showing how our framework may be useful for analyzing price dispersion as a function of sellers and buyers' network positions.

Finally, in Chapter 3 we study the problem of price competition and free entry in networked markets subject to congestion effects. In many environments, such as communication networks in which network flows are allocated, or transportation networks in which traffic is directed through the underlying road architecture, congestion plays an important role. In particular, we consider a network with multiple origins and a common destination node, where each link is owned by a firm that sets prices in order to maximize profits, whereas users want to minimize the total cost they face, which is given by the congestion cost plus the prices set by firms. In this environment, we introduce the notion of Markovian traffic equilibrium to establish the existence and uniqueness of a pure strategy price equilibrium, without assuming that the demand functions are concave nor imposing particular functional forms for the latency functions. We derive explicit conditions to guarantee existence and uniqueness of equilibria. Given this existence and uniqueness result, we apply our framework to study entry decisions and welfare, and establish that in congested markets with free entry, the number of firms exceeds the social optimum.

Lessons from History for Transitions to a Low Carbon Economy

4 p.