LTO- laitteiden vuosihyötysuhteiden vertailututkimus

Tämän työn tavoitteena oli laskea ja vertailla eroja lämmön talteenottolaitteistojen vuosihyötysuhteissa. Tavoitteena oli erityisesti löytää selkeät perusteet Suomen Rakennusmääräyskokoelman osassa D2 esitetyille arvoille vuosihyötysuhdetta laskettaessa. Työn kirjallisuusosassa on käsitelty yleisellä tasolla erityyppisten lämmön talteenottolaitteistojen teoriaa, toimintaperiaatteita ja soveltuvuutta erilaisiin käyttöolosuhteisiin. Työn empiirisessä osassa selvitettiin laboratorio-olosuhteissa virtauksessa mitattujen lämpötila- ja kosteusolosuhteiden vaikutusta lämmön talteenottolaitteiden toimintaan. Lisäksi työssä esitellään yleisellä tasolla mittauksissa käytettyjen mittalaitteiden toimintaa. Suoritettujen mittausten ja laskennan perusteella havaittiin, että laitteistojen vuosihyötysuhteiden välille saatiin odotetunlaisia eroja. Parhaimpiin tuloksiin päästiin regeneratiivisella lämmön talteenottolaitteella.

Prosessinostureita valmistavan liiketoimintayksikön arvoverkoston kustannusrakenne

Työn tarkoituksena on tutkia prosessinosturiliiketoiminnan rajatun arvoketjun ja - verkoston kustannuksia. Tavoitteena on selvittää valittujen vaihtoehtoisten valmistuspaikkojen toimintojen pohjalta yleinen arvoketju kustannuskertymineen. Lisäksi tavoitteena on kehittää taulukkolaskentaohjelmistoon perustuva laskentamalli tai perustyökalu kustannusten kasautumisen arviointiin. Edelleen pyrkimyksenä on löytää rakennetusta mallin avulla kehitys- ja jatkotoimenpiteiden kohteita. Työssä perehdytään aluksi arvoketju -viitekehykseen ja niihin seikkoihin joista se muodostuu kirjallisuudesta löytyvän tiedon pohjalta. Arvoketjuajattelu on yksinkertaisimmillaan yrityksen toimintojen tarkastelua kilpailukyvyn ja -edun näkökulmasta. Liiketoiminnan kehittyminen verkostomaiseksi vaatii kuitenkin laajemman ¿ arvoverkosto - tarkastelunäkökulman. Toisaalta liiketoiminnan pidemmän aikavälin kilpailukyvyn suunnittelu edellyttää syvällisempää arvoketjujen ja toimintojen tarkastelua ja hallintaa, jolloin tarvitaan kehittyneempiä laskentatoimen menetelmiä ja kustannuslaskentajärjestelmiä. Tutkimuksen empiirisessä osiossa arvoketjuajattelua ja arvoverkostoviitekehystä sekä kustannuslaskentamenetelmiä sovelletaan käytännön tapauksiin. Tulokset osoittavat tutkimukseen valittujen neljän valmistuspaikan kustannuskertymän ja -rakenteen. Kustannuskertymältään alhaisimmaksi osoittautui tuotantolaitos Saudi-Arabiassa, kunloppuasiakkaan sijainti on Qatarissa. Puolalainen tehdas osoittautui puolestaankilpailukykyisimmäksi, kun nosturin toimitusosoite on Italian pohjoisosaan. Tulosten perusteella kustannusrakenteiden suurimmat kustannuserät ovat kuljetus-, teräsrakenteen valmistus- ja suunnittelutoiminnot.

Kansainvälisen suunnitteluprojektin malliproseduuri ja riskit - Case Viro

Useissa suomalaisissa rakennus- tai suunnitteluyrityksissä on selkeät tavoitteet ja odotukset liiketoiminnan kasvulle. Kasvun mahdollisuudet kotimarkkinoilla ovat rajalliset. Liiketoiminnan kasvua on haettava kotimarkkinoiden ulkopuolelta.Liiketoiminnan kasvua haettaessa alan yritykset ovat nopeasti kansainvälistyneet ja etabloituneet lähialueille. Erityisesti etabloitumista on tapahtunut Baltiaan, Viroon. Heräte tämän työn tekemiseen syntyi case-yrityksentoimenpiteistä kansainväistymisessä ja etabloitumisen aiheuttamasta oletettua suuremmasta kustannusten kehittymisestä. Tutkimuksella ja toimenpiteillä tuetaan etabloitumiskehitystä ja parannetaan liiketoimintaprojektin kustannustehokkuutta. Tutkimuksen tavoitteena oli case-yrityksen toimitusprosessin kuvaaminen, suositeltavan toimitusmallin rakentaminen liiketoimintaprojektille ja kohdemaan riskien kuvaaminen projektiriskikartalle. Kansainvälisen projektiliiketoiminnan erityispiirteitä ovat toimintaympäristön ja asiakkaiden erilaisuus, erilaiset pelisäännöt ja tavat toimia, erilainen kulttuuri ja arvot, tuntematon markkinoiden kysyntä- ja tarjontatilanne. Kansainvälisessä projektiliiketoiminnassa joudumme sopeutumaan ja sopeuttamaan totuttua toimintaamme toisenlaisiin olosuhteisiin. Toisenlaisista olosuhteista johtuen kotimarkkinoille ja kotimaisiin asiakastoimituksiin laadittuun toimintajärjestelmään kuvattu prosessimalli ei sellaisenaan ole toimiva. Samanaikaisesti riskikartta muodostuu kohdemaasta johtuen hyvin erilaiseksi. Tutkimuksen lähtökohta oli toisenlaisesta markkinasta, valituista toimitusprojekteista ja kokemuksesta oppiminen. Tutkimuksen tuloksena rakentui liiketoimintaprojektimalli, joka on selkeästivaiheistettu, roolitettu ja vastuutettu. Lisäksi toisenlaisista markkinoista ja projektimallista johtuen kuvattiin kohdemaan projektiriskikartta. Tutkimuksessa kuvattu liiketoimintaprojektimalli ja kohdemaan mukainen projektiriskikartta toimivat yrityksen seuraavana kehitysaskeleena toiminnan vakauttamisessa. Henkilöstön roolia ja kumppanuuksia tulee kuitenkin jatkossa tarkastella. Työn tuloksena syntyi yksittäisen yrityksen liiketoimintaprojektimallin projektiosien ja roolien kuvaus sekä riskikartta. Työn tuloksen arvioidaan selkeyttävän yrityksen liiketoimintaa ja osaltaan varmistavan yrityksen kansainvälisen liiketoiminnan tavoitteiden saavuttamista.

Paperiteollisuusyrityksen hankintaprosessien parantaminen - Case M-real

Tämä tutkimus käsittelee teollisuusyrityksen hankintaprosessien parantamista. Tavoitteena oli selvittää, millaisilla toimenpiteillä raakaaineiden ja MRO (maintenance, repair and operating)-tuotteiden hankintaprosesseista saadaan toimivia ja tehokkaita. Tutkielmassa tarkastellaan hankintaprosessiin vaikuttavia asioita, erityisesti keskittämistä sekä informaatioteknologiaa, ja tuodaan esille erilaisia hankintaprosessin parantamiseen tähtääviä lähestymistapoja. Tutkimus toteutettiin laadullisena tapaustutkimuksena. Empiirinen aineisto kerättiin kohdeyritys M-realilla tehtyjen haastattelujen sekä havainnoinnin avulla. Tutkimuksessa havaittiin, että raaka-aineiden hankintaprosessia voidaan tehostaa lisäämällä automatiikkaa sekä parantamalla yhteistyötä hankintaprosessiin osallistuvien tahojen kesken. MRO-tuotteiden hankintaa voidaan tehostaa monilla operationaalisilla toimenpiteillä, kuten yksinkertaistamalla hankintaehdotuksen tekemistä. Yhtenä keskeisimpänä tutkimustuloksena on se, että toiminnanohjausjärjestelmä on merkittävimpiä hankintaprosessin parantamista rajoittavia tekijöitä. Merkittävänä tutkimustuloksena voidaan pitää myös sitä, että hankintaprosessin osien keskittämisen myötä kosketus paikallisiin asioihin vähenee, mutta tämä ei ole kuitenkaan ylivoimainen este hankintaprosessin tehokkaalle hoitamiselle. Tutkimuksessa havaittiin, että informaatioteknologian kehittymisen myötä hankintaprosessi on nopeutunut.

The last days of dying stroke patients referred to a palliative care consult team in an acute hospital.

BACKGROUND AND PURPOSE: Needs of patients dying from stroke are poorly investigated. We aim to assess symptoms of these patients referred to a palliative care consult team, and to review their treatment strategies. METHODS: All charts of patients dying from stroke in a tertiary hospital, and referred consecutively to a palliative care consultant team from 2000 to 2005, were reviewed retrospectively. Symptoms, ability to communicate, treatments, circumstances and causes of death were collected. RESULTS: Forty-two patients were identified. Median NIH Stroke Scale on admission was 21. The most prevalent symptoms were dyspnoea (81%), and pain (69%). Difficulties or inability to communicate because of aphasia or altered level of consciousness were present in 93% of patients. Pharmacological respiratory treatments consisted of anti-muscarinic drugs (52%), and opioids (33%). Pain was mainly treated by opioids (69%). During the last 48 h of life, 81% of patients were free of pain and 48% of respiratory distress. The main causes of death were neurological complications in 38% of patients, multiple medical complications in 36%, and specific medical causes in 26%. CONCLUSIONS: Patients dying from stroke and referred to a palliative care consult team have multiple symptoms, mainly dyspnoea and pain. Studies are warranted to develop specific symptoms assessment tools in non-verbal stroke patients, to accurately assess patients' needs, and to measure effectiveness of palliative treatments.

Psykologinen sopimus: työntekijän näkökulma

Työsopimusta solmittaessa syntyy työntekijänja työnantajan välille, kuin huomaamatta myös psykologinen sopimus. Tutkimuksentavoitteena on selvittää millaisia ovat kohdeyrityksen työntekijöiden psykologiset sopimukset, rikotaanko näitä sopimuksia ja kuinka työntekijät reagoivat mahdollisiin rikkomuksiin. Tutkimuksen kohderyhmänä on seitsemän työntekijää, jotka työskentelevät suuressa teollisuusyrityksessä Suomessa. Tutkimuksessa käytetty tutkimusmenetelmä on kvalitatiivinen. Tutkimuksen empiirinen aineisto koostuu teemahaastatteluista. Haastatteluissa pyrittiin selvittämään työntekijöiden psykologisiin sopimuksiin liittyviä käsityksiä, kokemuksia ja tulkintoja. Aineiston analyysissa tulkinta pohjautuu käsitteellisessä osiossa esitettyihin käsitteisiin ja malleihin. Tutkimustulosten mukaan haastateltavien työntekijöiden psykologiset sopimukset ovat hyvin transaktionaalisia. Psykologisia sopimuksia on myös rikottu. Rikkomuksiin haastateltavat ovat reagoineet keskustelemalla työnantajan kanssa tai olemalla vaiti ja sopeutumalla tilanteeseen. Rikkomukset ovat myös vaikuttaneet negatiivisesti haastateltavien työkäyttäytymiseen.

Pathophysiology of muscle dysfunction in COPD

Muscle dysfunction often occurs in patients with chronic obstructive pulmonary disease (COPD) and may involve both respiratory and locomotor (peripheral) muscles. The loss of strength and/or endurance in the former can lead to ventilatory insufficiency, whereas in the latter it limits exercise capacity and activities of daily life. Muscle dysfunction is the consequence of complex interactions between local and systemic factors, frequently coexisting in COPD patients. Pulmonary hyperinflation along with the increase in work of breathing that occur in COPD appear as the main contributing factors to respiratory muscle dysfunction. By contrast, deconditioning seems to play a key role in peripheral muscle dysfunction. However, additional systemic factors, including tobacco smoking, systemic inflammation, exercise, exacerbations, nutritional and gas exchange abnormalities, anabolic insufficiency, comorbidities and drugs, can also influence the function of both respiratory and peripheral muscles, by inducing modifications in their local microenvironment. Under all these circumstances, protein metabolism imbalance, oxidative stress, inflammatory events, as well as muscle injury may occur, determining the final structure and modulating the function of different muscle groups. Respiratory muscles show signs of injury as well as an increase in several elements involved in aerobic metabolism (proportion of type I fibers, capillary density, and aerobic enzyme activity) whereas limb muscles exhibit a loss of the same elements, injury, and a reduction in fiber size. In the present review we examine the current state of the art of the pathophysiology of muscle dysfunction in COPD.

Supply chain integration: studies on linking customer responsiveness and operational efficiency in logistics policy planning

Abstract The research problem in the thesis deals with improving the responsiveness and efficiency of logistics service processes between a supplier and its customers. The improvement can be sought by customizing the services and increasing the coordination of activities between the different parties in the supply chain. It is argued that to achieve coordination the parties have to have connections on several levels. In the framework employed in this research, three contexts are conceptualized at which the linkages can be planned: 1) the service policy context, 2) the process coordination context, and 3) the relationship management context. The service policy context consists of the planning methods by which a supplier analyzes its customers' logistics requirements and matches them with its own operational environment and efficiency requirements. The main conclusion related to the service policy context is that it is important to have a balanced selection of both customer-related and supplier-related factors in the analysis. This way, while the operational efficiency is planned a sufficient level of service for the most important customers is assured. This kind of policy planning involves taking multiple variables into the analysis, and there is a need to develop better tools for this purpose. Some new approaches to deal with this are presented in the thesis.The process coordination context and the relationship management context deal with the issues of how the implementation of the planned service policies can be facilitated in an inter-organizational environment. Process coordination includes typically such mechanisms as control rules, standard procedures and programs, but inhighly demanding circumstances more integrative coordination mechanisms may be necessary. In the thesis the coordination problems in third-party logistics relationship are used as an example of such an environment. Relationship management deals with issues of how separate companies organize their relationships to improve the coordination of their common processes. The main implication related to logistics planning is that by integrating further at the relationship level, companies can facilitate the use of the most efficient coordination mechanisms and thereby improve the implementation of the selected logistics service policies. In the thesis, a case of a logistics outsourcing relationship is used to demonstrate the need to address the relationship issues between the service provider andthe service buyer before the outsourcing can be done.The dissertation consists of eight research articles and a summarizing report. The principal emphasis in the articles is on the service policy planning context, which is the main theme of six articles. Coordination and relationship issues are specifically addressed in two of the papers.

Database Rights in Safe European Home: The Path to More Rigorous Protection of Information

1. Introduction "The one that has compiled ... a database, the collection, securing the validity or presentation of which has required an essential investment, has the sole right to control the content over the whole work or over either a qualitatively or quantitatively substantial part of the work both by means of reproduction and by making them available to the public", Finnish Copyright Act, section 49.1 These are the laconic words that implemented the much-awaited and hotly debated European Community Directive on the legal protection of databases,2 the EDD, into Finnish Copyright legislation in 1998. Now in the year 2005, after more than half a decade of the domestic implementation it is yet uncertain as to the proper meaning and construction of the convoluted qualitative criteria the current legislation employs as a prerequisite for the database protection both in Finland and within the European Union. Further, this opaque Pan-European instrument has the potential of bringing about a number of far-reaching economic and cultural ramifications, which have remained largely uncharted or unobserved. Thus the task of understanding this particular and currently peculiarly European new intellectual property regime is twofold: first, to understand the mechanics and functioning of the EDD and second, to realise the potential and risks inherent in the new legislation in economic, cultural and societal dimensions. 2. Subject-matter of the study: basic issues The first part of the task mentioned above is straightforward: questions such as what is meant by the key concepts triggering the functioning of the EDD such as presentation of independent information, what constitutes an essential investment in acquiring data and when the reproduction of a given database reaches either qualitatively or quantitatively the threshold of substantiality before the right-holder of a database can avail himself of the remedies provided by the statutory framework remain unclear and call for a careful analysis. As for second task, it is already obvious that the practical importance of the legal protection providedby the database right is in the rapid increase. The accelerating transformationof information into digital form is an existing fact, not merely a reflection of a shape of things to come in the future. To take a simple example, the digitisation of a map, traditionally in paper format and protected by copyright, can provide the consumer a markedly easier and faster access to the wanted material and the price can be, depending on the current state of the marketplace, cheaper than that of the traditional form or even free by means of public lending libraries providing access to the information online. This also renders it possible for authors and publishers to make available and sell their products to markedly larger, international markets while the production and distribution costs can be kept at minimum due to the new electronic production, marketing and distributionmechanisms to mention a few. The troublesome side is for authors and publishers the vastly enhanced potential for illegal copying by electronic means, producing numerous virtually identical copies at speed. The fear of illegal copying canlead to stark technical protection that in turn can dampen down the demand for information goods and services and furthermore, efficiently hamper the right of access to the materials available lawfully in electronic form and thus weaken the possibility of access to information, education and the cultural heritage of anation or nations, a condition precedent for a functioning democracy. 3. Particular issues in Digital Economy and Information Networks All what is said above applies a fortiori to the databases. As a result of the ubiquity of the Internet and the pending breakthrough of Mobile Internet, peer-to-peer Networks, Localand Wide Local Area Networks, a rapidly increasing amount of information not protected by traditional copyright, such as various lists, catalogues and tables,3previously protected partially by the old section 49 of the Finnish Copyright act are available free or for consideration in the Internet, and by the same token importantly, numerous databases are collected in order to enable the marketing, tendering and selling products and services in above mentioned networks. Databases and the information embedded therein constitutes a pivotal element in virtually any commercial operation including product and service development, scientific research and education. A poignant but not instantaneously an obvious example of this is a database consisting of physical coordinates of a certain selected group of customers for marketing purposes through cellular phones, laptops and several handheld or vehicle-based devices connected online. These practical needs call for answer to a plethora of questions already outlined above: Has thecollection and securing the validity of this information required an essential input? What qualifies as a quantitatively or qualitatively significant investment? According to the Directive, the database comprises works, information and other independent materials, which are arranged in systematic or methodical way andare individually accessible by electronic or other means. Under what circumstances then, are the materials regarded as arranged in systematic or methodical way? Only when the protected elements of a database are established, the question concerning the scope of protection becomes acute. In digital context, the traditional notions of reproduction and making available to the public of digital materials seem to fit ill or lead into interpretations that are at variance with analogous domain as regards the lawful and illegal uses of information. This may well interfere with or rework the way in which the commercial and other operators have to establish themselves and function in the existing value networks of information products and services. 4. International sphere After the expiry of the implementation period for the European Community Directive on legal protection of databases, the goals of the Directive must have been consolidated into the domestic legislations of the current twenty-five Member States within the European Union. On one hand, these fundamental questions readily imply that the problemsrelated to correct construction of the Directive underlying the domestic legislation transpire the national boundaries. On the other hand, the disputes arisingon account of the implementation and interpretation of the Directive on the European level attract significance domestically. Consequently, the guidelines on correct interpretation of the Directive importing the practical, business-oriented solutions may well have application on European level. This underlines the exigency for a thorough analysis on the implications of the meaning and potential scope of Database protection in Finland and the European Union. This position hasto be contrasted with the larger, international sphere, which in early 2005 does differ markedly from European Union stance, directly having a negative effect on international trade particularly in digital content. A particular case in point is the USA, a database producer primus inter pares, not at least yet having aSui Generis database regime or its kin, while both the political and academic discourse on the matter abounds. 5. The objectives of the study The above mentioned background with its several open issues calls for the detailed study of thefollowing questions: -What is a database-at-law and when is a database protected by intellectual property rights, particularly by the European database regime?What is the international situation? -How is a database protected and what is its relation with other intellectual property regimes, particularly in the Digital context? -The opportunities and threats provided by current protection to creators, users and the society as a whole, including the commercial and cultural implications? -The difficult question on relation of the Database protection and protection of factual information as such. 6. Dsiposition The Study, in purporting to analyse and cast light on the questions above, is divided into three mainparts. The first part has the purpose of introducing the political and rationalbackground and subsequent legislative evolution path of the European database protection, reflected against the international backdrop on the issue. An introduction to databases, originally a vehicle of modern computing and information andcommunication technology, is also incorporated. The second part sets out the chosen and existing two-tier model of the database protection, reviewing both itscopyright and Sui Generis right facets in detail together with the emergent application of the machinery in real-life societal and particularly commercial context. Furthermore, a general outline of copyright, relevant in context of copyright databases is provided. For purposes of further comparison, a chapter on the precursor of Sui Generi, database right, the Nordic catalogue rule also ensues. The third and final part analyses the positive and negative impact of the database protection system and attempts to scrutinize the implications further in the future with some caveats and tentative recommendations, in particular as regards the convoluted issue concerning the IPR protection of information per se, a new tenet in the domain of copyright and related rights.

Strategy Implementation Bottlenecks: Identification, Analysis and Removal

This thesis investigates the strategy implementation process of enterprices; a process whichhas lacked the academic attentioon compared with a rich strategy formation research trdition. Strategy implementation is viewed as a process ensuring tha the strtegies of an organisation are realised fully and quickly, yet with constant consideration of changing circumstances. The aim of this sudy is to provide a framework for identifying, analysing and removing the strategy implementation bottleneck af an organization and thus for intesifying its strategy process.The study is opened by specifying the concept, tasks and key actors of strategy implementation process; especially arguments for the critical implementation role of the top management are provided. In order to facilitate the analysis nad synthetisation of the core findings of scattered doctrine, six characteristic approaches to strategy implementation phenomenon are identified and compared. The Bottleneck Framework is introduced as an instrument for arranging potential strategy realisation problems, prioritising an organisation's implementation obstacles and focusing the improvement measures accordingly. The SUCCESS Framework is introduced as a mnemonic of the seven critical factors to be taken into account when promoting sttrategy implementation. Both frameworks are empirically tested by applying them to real strategy implementation intesification process in an international, industrial, group-structured case enterprise.

Los gitanos en España: mercado de trabajo y educación: crónica de un desencuentro

Los gitanos en Europa y, concretamente en España, se han caracterizado por mantener una situación de marginación social y cultural a pesar de los cambios experimentados por las sociedades (económicos, demográficos, sociales y políticos). En los últimos cuarenta años, los gitanos se han ido adaptando a las diferentes coyunturas económicas y sociales que les han afectado pero que no les han comportado, a una gran parte, la salida de la situación marginal en que viven. El trabajo que presentamos, aunque focalizado en el mercado laboral y la educación, presenta la situación de los gitanos ante los cambios acaecidos y su actual situación laboral y educativa. Esta última es uno de sus principales problemas ya que la escasa titulación y la distancia (cuando no rechazo) que expresan hacia el sistema educativo español tal como está concebido les sitúa y les condena a posiciones subordinadas en el mercado laboral, que también hay que decir que en ocasiones no quieren abandonar.

Los espacios residenciales de tipo privativo y la construcción de la nueva ciudad: visiones de privatopía

La proliferación de los desarrollos residenciales con acceso restringido y de tipo privativo (condominios, supermanzanas, countries, barrios cerrados, etc.) se presentan en el texto como reflejo, a la vez que resultado, de los nuevos procesos de urbanización. Las características de estos desarrollos reflejan los cambios más generales que se van produciendo en el espacio urbano: la privatización, la fragmentación y la tematización, entendida ésta como la construcción de espacios de simulación. A través del análisis bibliográfico, y de la reflexión sobre unos casos de estudio en la región metropolitana de Nueva York, el trabajo incide sobre las causas (el neoliberalismo, los patrones de consumo global) y las consecuencias de la proliferación de los espacios residenciales de tipo privativo: la fragmentación urbana, la privatización y la introducción de nuevos patrones de segregación.

Pierre Vilar, historiador del capitalismo

La obra histórica de Pierre Vilar ha estado siempre vinculada a su preocupación por el presente y el porvenir de las sociedades humanas. Desde esta perspectiva, Vilar centró gran parte de sus ocupaciones historiográficas en entender el cambio histórico, siendo el nacimiento del capitalismo uno de sus temas centrales al posibilitarle la comprensión globalizadora de la transmutación de un modelo de sociedad a otro. En este sentido, su obra magna sobre Cataluña, serviría para demostrar que ésta tuvo su particular forma de insertarse en el capitalismo y que en medio de las controversias políticas sobre el hecho nacional no había que olvidar tan importante circunstancia.

Cardioinhibitory reflex due to a karate kick: a case report.

This article describes the case of a 17-year-old adolescent boy who received a foot kick in the trunk area from an expert in karate. He presented with immediate cardiocirculatory arrest. After a prolonged resuscitation, he was transferred to a hospital where he died 5 days later without ever regaining consciousness. Postmortem investigations including autopsy, radiology, histology, toxicology, and postmortem chemistry were performed that showed signs of multiple organ failure, an acute hemorrhage in the region of the celiac plexus, and signs of medical resuscitation. No preexisting disease, particularly those concerning the heart, was objectified. The cause of death was attributed to multiple organ failure after a prolonged cardiocirculatory arrest. Concerning the origin of the cardiac arrest, 2 hypotheses were considered-a cardioinhibitory reflex and a cardiac contusion (commotio cordis). Because of the presence of traumatic lesions in the celiac plexus, the first hypothesis was finally submitted. This case is reported because rare cases of sudden death from celiac reflex are described in the literature where it is almost impossible to find references with accurate documentation. The presented case confirms the importance of detailed documentation of the circumstances and postmortem investigations to establish a diagnosis of death due to cardioinhibitory reflex.

Generation and interconnection capacity expansion in cross-border electricity markets : the need for policy coordination

Electricity is a strategic service in modern societies. Thus, it is extremely important for governments to be able to guarantee an affordable and reliable supply, which depends to a great extent on an adequate expansion of the generation and transmission capacities. Cross- border integration of electricity markets creates new challenges for the regulators, since the evolution of the market is now influenced by the characteristics and policies of neighbouring countries. There is still no agreement on why and how regions should integrate their electricity markets. The aim of this thesis is to improve the understanding of integrated electricity markets and how their behaviour depends on the prevailing characteristics of the national markets and the policies implemented in each country. We developed a simulation model to analyse under what circumstances integration is desirable. This model is used to study three cases of interconnection between two countries. Several policies regarding interconnection expansion and operation, combined with different generation capacity adequacy mechanisms, are evaluated. The thesis is composed of three papers. The first paper presents a detailed description of the model and an analysis of the case of Colombia and Ecuador. It shows that market coupling can bring important benefits, but the relative size of the countries can lead to import dependency issues in the smaller country. The second paper compares the case of Colombia and Ecuador with the case of Great Britain and France. These countries are significantly different in terms of electricity sources, hydro- storage capacity, complementarity and demand growth. We show that complementarity is essential in order to obtain benefits from integration, while higher demand growth and hydro- storage capacity can lead to counterintuitive outcomes, thus complicating policy design. In the third paper, an extended version of the model presented in the first paper is used to analyse the case of Finland and its interconnection with Russia. Different trading arrangements are considered. We conclude that unless interconnection capacity is expanded, the current trading arrangement, where a single trader owns the transmission rights and limits the flow during peak hours, is beneficial for Finland. In case of interconnection expansion, market coupling would be preferable. We also show that the costs of maintaining a strategic reserve in Finland are justified in order to limit import dependency, while still reaping the benefits of interconnection. In general, we conclude that electricity market integration can bring benefits if the right policies are implemented. However, a large interconnection capacity is only desirable if the countries exhibit significant complementarity and trust each other. The outcomes of policies aimed at guaranteeing security of supply at a national level can be quite counterintuitive due to the interactions between neighbouring countries and their effects on interconnection and generation investments. Thus, it is important for regulators to understand these interactions and coordinate their decisions in order to take advantage of the interconnection without putting security of supply at risk. But it must be taken into account that even when integration brings benefits to the region, some market participants lose and might try to hinder the integration process. -- Dans les sociétés modernes, l'électricité est un service stratégique. Il est donc extrêmement important pour les gouvernements de pouvoir garantir la sécurité d'approvisionnement à des prix abordables. Ceci dépend en grande mesure d'une expansion adéquate des capacités de génération et de transmission. L'intégration des marchés électriques pose des nouveaux défis pour les régulateurs, puisque l'évolution du marché est maintenant influencée par les caractéristiques et les politiques des pays voisins. Il n'est pas encore claire pourquoi ni comment les marches électriques devraient s'intégrer. L'objectif de cette thèse est d'améliorer la compréhension des marchés intégrés d'électricité et de leur comportement en fonction des caractéristiques et politiques de chaque pays. Un modèle de simulation est proposé pour étudier les conditions dans lesquelles l'intégration est désirable. Ce modèle est utilisé pour étudier trois cas d'interconnexion entre deux pays. Plusieurs politiques concernant l'expansion et l'opération de l'interconnexion, combinées avec différents mécanismes de rémunération de la capacité, sont évalués. Cette thèse est compose de trois articles. Le premier présente une description détaillée du modèle et une analyse du cas de la Colombie et de l'Equateur. Il montre que le couplage de marchés peut amener des bénéfices importants ; cependant, la différence de taille entre pays peut créer des soucis de dépendance aux importations pour le pays le plus petit. Le second papier compare le cas de la Colombie et l'Equateur avec le cas de la Grande Bretagne et de la France. Ces pays sont très différents en termes de ressources, taille des réservoirs d'accumulation pour l'hydro, complémentarité et croissance de la demande. Nos résultats montrent que la complémentarité joue un rôle essentiel dans l'obtention des bénéfices potentiels de l'intégration, alors qu'un taux élevé de croissance de la demande, ainsi qu'une grande capacité de stockage, mènent à des résultats contre-intuitifs, ce qui complique les décisions des régulateurs. Dans le troisième article, une extension du modèle présenté dans le premier article est utilisée pour analyser le cas de la Finlande et de la Russie. Différentes règles pour les échanges internationaux d'électricité sont considérées. Nos résultats indiquent qu'à un faible niveau d'interconnexion, la situation actuelle, où un marchand unique possède les droits de transmission et limite le flux pendant les heures de pointe, est bénéfique pour la Finlande. Cependant, en cas d'expansion de la capacité d'interconnexion, «market coupling» est préférable. préférable. Dans tous les cas, la Finlande a intérêt à garder une réserve stratégique, car même si cette politique entraine des coûts, elle lui permet de profiter des avantages de l'intégration tout en limitant ca dépendance envers les importations. En général, nous concluons que si les politiques adéquates sont implémentées, l'intégration des marchés électriques peut amener des bénéfices. Cependant, une grande capacité d'interconnexion n'est désirable que si les pays ont une complémentarité importante et il existe une confiance mutuelle. Les résultats des politiques qui cherchent à préserver la sécurité d'approvisionnement au niveau national peuvent être très contre-intuitifs, étant données les interactions entre les pays voisins et leurs effets sur les investissements en génération et en interconnexion. Il est donc très important pour les régulateurs de comprendre ces interactions et de coordonner décisions à fin de pouvoir profiter de l'interconnexion sans mettre en danger la sécurité d'approvisionnement. Mais il faut être conscients que même quand l'intégration amène de bénéfices pour la région, certains participants au marché sont perdants et pourraient essayer de bloquer le processus d'intégration.