863 resultados para Complicated Grief
Resumo:
Kilpailukykyisyyden säilyttäminen alati kehittyvillä markkinoilla vaatii ajanmukaisten tietojärjestelmien käyttöä. Eräs tärkeimmistä tällaisista järjestelmistä on organisaatiossa käytössä oleva tiedonhallintajärjestelmä, jota käytetään yrityksessä kulutettavan ja tuotettavan tiedon hallitsemiseen. Käytössä olevan tiedonhallintajärjestelmän vaihtaminen modernimpaan on monimutkainen prosessi, joka alkaa uuden järjestelmän valinnasta ja jatkuu järjestelmän käyttöönottamisella. Käyttöönottoon kuuluu tarpeellisten vanhojen sovellusten integroiminen osaksi uutta järjestelmää sekä käyttäjien kouluttaminen uuden järjestelmän vaatimiin työtapoihin. Diplomityössä on perehdytty uuden ALMAtiedonhallintajärjestelmän käyttöönottoon prosessiteollisuuden suunnittelu- ja konsultointiyritys CTS Engtec Oy:ssä. Työn puitteissa liitettiin kaksi CTS:llä käytössä olevaa sovellusta, CTS Pine ja PMMATE, osaksi uutta tiedonhallintajärjestelmää. Lisäksi työssä on tutustuttu tiedonhallintajärjestelmiin liittyviin käsitteisiin.
Resumo:
This Master’s thesis addresses different approaches using which a foreign IT company could enter Russian manufacturing industry with its enterprise information systems and IT services. In order to define the most suitable market entry approach, several aspects related to Russian manufacturing enterprises are studied. These aspects include challenges of doing ICT business with the previously mentioned enterprises, their perception of ICT role and their ICT preferences, as well as their buying behavior related to acquisition of information systems (IS). The study results show that there are several challenges that can be faced by a foreign IT vendor when starting conducting ICT business with Russian manufacturing enterprises. The results also show that Russian manufacturing industry is still rather immature in sense of business process automation, and its IT buying behavior is rather specific and complicated. The results suggest that an efficient way to approach these enterprises is through a network of trusted partners that consists of reliable Russian IS integrators and business consultants having established connections to Russian manufacturing companies and possessing the needed competence.
Resumo:
CRM-järjestelmän avulla pyritään yleisesti tehostamaan liiketoimintaprosesseja. Yrityksestä, kuin myös toimialasta riippuen hyödyt sekä tavoitteet vaihtelevat jonkin verran. Usein CRM-järjestelmän avulla saavutettavien hyötyjen mittaaminen ja arviointi organisaatiossa koetaan hankalaksi ja täten todellinen hyötyjen arviointi jää suppeaksi. Tämän tutkimuksen tavoitteena oli kartoittaa etuja, joita CRM-järjestelmän käyttöönotto on todellisuudessa tuonut yrityksille. Tutkimus kulminoituu laskentamalliin, jonka avulla CRM käytön hyödyt konvertoidaan konkreettiseksi rahasummaksi. Tutkimuksessa pyritään vastaamaan seuraaviin tutkimuskysymyksiin: 1. Kun yritys suunnitteli CRM-sovelluksen käyttöönottoa, mitkä olivat järjestelmälle asetetut tavoitteet? 2. Onko yritys saavuttanut CRM-järjestelmälle asetetut tavoitteet? 3. Onko yritys saavuttanut odottamattomia hyötyjä CRM-järjestelmän käytön avulla? 4. Mitkä ovat CRM-järjestelmän tärkeimmät kehityskohteet käyttökokemusten perusteella? Tutkimus perustuu CRM-kirjallisuuden avulla luotuun teoriaviitekehykseen. Teoriaviitekehyksen pohjalta luotiin ideaalimalli ja mallin pohjalta web-survey -kysely. Kyselyn tulosten perusteella toteutettiin haastatteluja, joilla pyrittiin saamaan tutkimustuloksiin syvyyttä.
Resumo:
The computer is a useful tool in the teaching of upper secondary school physics, and should not have a subordinate role in students' learning process. However, computers and computer-based tools are often not available when they could serve their purpose best in the ongoing teaching. Another problem is the fact that commercially available tools are not usable in the way the teacher wants. The aim of this thesis was to try out a novel teaching scenario in a complicated subject in physics, electrodynamics. The didactic engineering of the thesis consisted of developing a computer-based simulation and training material, implementing the tool in physics teaching and investigating its effectiveness in the learning process. The design-based research method, didactic engineering (Artigue, 1994), which is based on the theoryof didactical situations (Brousseau, 1997), was used as a frame of reference for the design of this type of teaching product. In designing the simulation tool a general spreadsheet program was used. The design was based on parallel, dynamic representations of the physics behind the function of an AC series circuit in both graphical and numerical form. The tool, which was furnished with possibilities to control the representations in an interactive way, was hypothesized to activate the students and promote the effectiveness of their learning. An effect variable was constructed in order to measure the students' and teachers' conceptions of learning effectiveness. The empirical study was twofold. Twelve physics students, who attended a course in electrodynamics in an upper secondary school, participated in a class experiment with the computer-based tool implemented in three modes of didactical situations: practice, concept introduction and assessment. The main goal of the didactical situations was to have students solve problems and study the function of AC series circuits, taking responsibility for theirown learning process. In the teacher study eighteen Swedish speaking physics teachers evaluated the didactic potential of the computer-based tool and the accompanying paper-based material without using them in their physics teaching. Quantitative and qualitative data were collected using questionnaires, observations and interviews. The result of the studies showed that both the group of students and the teachers had generally positive conceptions of learning effectiveness. The students' conceptions were more positive in the practice situation than in the concept introduction situation, a setting that was more explorative. However, it turned out that the students' conceptions were also positive in the more complex assessment situation. This had not been hypothesized. A deeper analysis of data from observations and interviews showed that one of the students in each pair was more active than the other, taking more initiative and more responsibilityfor the student-student and student-computer interaction. These active studentshad strong, positive conceptions of learning effectiveness in each of the threedidactical situations. The group of less active students had a weak but positive conception in the first iv two situations, but a negative conception in the assessment situation, thus corroborating the hypothesis ad hoc. The teacher study revealed that computers were seldom used in physics teaching and that computer programs were in short supply. The use of a computer was considered time-consuming. As long as physics teaching with computer-based tools has to take place in special computer rooms, the use of such tools will remain limited. The affordance is enhanced when the physical dimensions as well as the performance of the computer are optimised. As a consequence, the computer then becomes a real learning tool for each pair of students, smoothly integrated into the ongoing teaching in the same space where teaching normally takes place. With more interactive support from the teacher, the computer-based parallel, dynamic representations will be efficient in promoting the learning process of the students with focus on qualitative reasoning - an often neglected part of the learning process of the students in upper secondary school physics.
Resumo:
Tämän tutkimuksen aiheena oli älypuhelimien käytettävyys naisnäkökulmasta. Aihe nousi esiin kesällä 2010 huomatessani, että älypuhelinmarkkinat ja –mainokset ovat hyvin pitkälle miehille suunnattuja. Etsiessäni materiaalia tuekseni tähän työhön huomasin, että sitä on erittäin vähän saatavilla. Tämän takia päätin toteuttaa työn käytettävyystestausprojektina. Projektin testiryhmä koostui naisista, jonka jäseniä pyydettiin suorittamaan valitsemillaan älypuhelimilla testitehtäviä. Testin jälkeen he vastasivat käytettävyystestauslomakkeissa olleisiin kysymyksiin, jotka koskivat testattuja älypuhelimia. Tutkimustuloksia analysoitaessa nousi esiin vähäinen tarve älypuhelimen ostamiseen. Tässä käytettävyystestausprojektissa lopputulos oli, että testaajat eivät kokeneet tarvetta ostaa vaikeasti hallittavaa sekä turhia sovelluksia sisältävää ja kallista älypuhelinta.
Resumo:
Investment decision-making on far-reaching innovation ideas is one of the key challenges practitioners and academics face in the field of innovation management. However, the management practices and theories strongly rely on evaluation systems that do not fit in well with this setting. These systems and practices normally cannot capture the value of future opportunities under high uncertainty because they ignore the firm’s potential for growth and flexibility. Real options theory and options-based methods have been offered as a solution to facilitate decision-making on highly uncertain investment objects. Much of the uncertainty inherent in these investment objects is attributable to unknown future events. In this setting, real options theory and methods have faced some challenges. First, the theory and its applications have largely been limited to market-priced real assets. Second, the options perspective has not proved as useful as anticipated because the tools it offers are perceived to be too complicated for managerial use. Third, there are challenges related to the type of uncertainty existing real options methods can handle: they are primarily limited to parametric uncertainty. Nevertheless, the theory is considered promising in the context of far-reaching and strategically important innovation ideas. The objective of this dissertation is to clarify the potential of options-based methodology in the identification of innovation opportunities. The constructive research approach gives new insights into the development potential of real options theory under non-parametric and closeto- radical uncertainty. The distinction between real options and strategic options is presented as an explanans for the discovered limitations of the theory. The findings offer managers a new means of assessing future innovation ideas based on the frameworks constructed during the course of the study.
Resumo:
This dissertation explores the complicated relations between Estonian, Latvian, and Lithuanian postwar refugees and American foreign policymakers between 1948 and 1960. There were seemingly shared interests between the parties during the first decade of the Cold War. Generally, Eastern European refugees refused to recognize Soviet hegemony in their homelands, and American policy towards the Soviet bloc during the Truman and Eisenhower administrations sought to undermine the Kremlin’s standing in the region. More specifically, Baltic refugees and State Department officials sought to preserve the 1940 non-recognition policy towards the Soviet annexation of the Baltic States. I propose that despite the seemingly natural convergence of interests, the American experiment of constructing a State-Private network revolving around fostering relations with exile groups was fraught with difficulties. These difficulties ultimately undermined any ability that the United States might have had to liberate the Baltic States from the Soviet Union. As this dissertation demonstrates, Baltic exiles were primarily concerned with preserving a high level of political continuity to the interwar republics under the assumption that they would be able to regain their positions in liberated, democratic societies. American policymakers, however, were primarily concerned with maintaining the non-recognition policy, the framework in which all policy considerations were analyzed. I argue that these two motivating factors created unnecessary tensions in American policy towards the Baltic republics in the spheres of psychological warfare as well as exile unity in the United States and Europe. Despite these shortcomings, I argue that out of the exiles’ failings was born a generation of Baltic constituents that blurred the political legitimacy line between exiles who sought to return home and ethnic Americans who were loyal to the United States. These Baltic constituents played an important role in garnering the support of the United States Congress, starting in the 1950s, but became increasingly influential after the 1956 Hungarian Revolution, despite the seemingly less important role Eastern Europe played in the Cold War. The actions of the Baltic constituents not only prevented the Baltic question from being forever lost in the memory hole of history, but actually created enough political pressure on the State Department that it was impossible to alter the long-standing policy of not recognizing the Soviet annexation of the Baltic States.
DPS-Like Peroxide Resistance Protein: Structural and Functional Studies on a Versatile Nanocontainer
Resumo:
Oxidative stress is a constant threat to almost all organisms. It damages a number of biomolecules and leads to the disruption of many crucial cellular functions. It is caused by reactive oxygen species (ROS), such as hydrogen peroxide (H
Resumo:
Operation Musketeer, a combined joint Anglo-French operation aimed at regaining control of the Suez Canal in 1956, has received much attention from scholars. The most common approach to the crisis has been to examine the political dimension. The political events that led Prime Minister Anthony Eden’s cabinet to decide to use military force against the wishes of their superior American ally and in the face of American economic pressure and a Soviet threat to attack Paris and London with rockets have been analysed thoroughly. This is particularly the case because the ceasefire and eventual withdrawal were an indisputable defeat of British policy in the Middle East. The military operation not only ruined Prime Minister Eden’s career, but it also diminished the prestige of Britain. It was the beginning of the end, some claim. The British Empire would never be the same. As the consequences of using force are generally considered more important than the military operations themselves, very little attention has been paid to the military planning of Operation Musketeer. The difference between the number of publications on Operation Corporate of the Falklands War and Operation Musketeer is striking. Not only has there been little previous research on the military aspects of Musketeer, the conclusions drawn in the existing works have not reached a consensus. Some historians, such as Correlli Barnett, compare Musketeer to the utter failures of the Tudor landings and Gallipoli. Among significant politicians, Winston Churchill, who had retired from the prime ministership only a year before the Suez Crisis, described the operation as “the most ill-conceived and ill-executed imaginable”. Colin McInnes, a well-known author on British defence policy, represents the middle view when he describes the execution as “far from failure”. Finally, some, like Julian Thompson, the Commander of 3 Commando Brigade during the Falklands War, rate the military action itself as being successful. The interpretation of how successful the handling of the Suez Crisis was from the military point of view depends very much on the approach taken and the areas emphasised in the subject. Frequently, military operations are analysed in isolation from other events. The action of a country’s armed forces is separated from the wider context and evaluated without a solid point of comparison. Political consequences are often used as validated criteria, and complicated factors contributing to military performance are ignored. The lack of comprehensive research on the military action has left room for an analysis concentrating on the military side of the crisis.
Resumo:
Intestinal complications after laparoscopic cholecystectomy are rare and usually caused by direct injury sustained on trocar insertion. However, intestinal ischaemia has been reported as an unusual complication of the pneumoperitoneum. We describe a 55-years-old patient who underwent an uneventful laparoscopic cholecystectomy after an episode of acute cholecystitis. Initial recovery was complicated by development of increasing abdominal pain which led to open laparotomy on day 2. Gangrene of the distal ileum and right-sided colon was detected and small bowel resection with right colectomy and primary anastomosis was performed. Histological examination of the resected ileum showed features of venous hemorragic infarction and trombosis. In view of the proximity of the operation it is assumed that ileal ischaemia was precipitated by carbon dioxide pneumoperitoneum. Some studies have been demonstrated that, within 30 minutes of establishing a pneumoperitoneum at an intraabdominal pressure of 16 mmHg, cardiac output, blood flow in the superior mesenteric artery and portal vein decrease progressively. Carbon dioxide pneumoperitoneum may lead to mechanical compression of the splanchnic veins and mesenteric vasoconstriction as a result of carbon dioxide absortion. The distribution of the ischaemic segment of intestine is also unusual as the most precarious blood supply is traditionally at the splenic flexure of the colon. It has been suggested that intermittent decompression of the abdomen reduces the risk of mesenteric ischaemia during penumoperitoneum especially in patients with predisposing clinical features for arteriosclerosis intestinal. In present patient was observed intestinal venous infarction what remains unclear but we think the carbon dioxide pneumoperitoneum have been related to it.
Resumo:
The authors report a case of the 15 year old young man, from endemic zone of schistosomiasis and with a chronic schistosomiasis, was admitted complaining of continuous pain in the right upper quadrant, spreaded to epigastrium and right lower quadrant which, began 10 days before. It was associated to fever, anorexia, hepatomegaly, esplenomegaly and signs of peritoneal irritation without clinical improvement. At laparotomy multiple liver microabscesses were found. Excluded the classic etiology, a liver biopsy was done and showed Schistossoma mansoni eggs. surrounded by the same inflamatory cells of microabscesses. This suggested that they have been the predisposing cause for the formation of liver abscesses, as shown in the literature. Schistosomiasis can be complicated with pylephlebitis, immunodepression and granulomatous reaction, centrallobular necrosis and a raise in the infection risk. The described data suggest the schistosomiasis as the etiology of hepatic microabscesses, mainly in endemic zones.
Resumo:
Traumatic diaphragmatic hernia is defined as a laceration of the diaphragm with an abdominal viscera herniation into the thorax. It is usually asymptomatic, with the exception of the cases with obstruction, strangulation, necrosis or perforation of the herniaded viscera. It is classified as acute, latent or chronic, in accordance with the evolutive period. At the latent phase, symptoms are indefinite and the radiological signals, which are suggestive of thoracic affections, are frequent and can induce a diagnosis error, leading to inadequate treatment.This article presents a case of chronic traumatic diaphragmatic hernia which was complicated by a gastricpleuralcutaneous fistula, due to an inadequate thoracic drainage. Considering that this is a chronic affection with an unquestionable surgical indication, due to the complications risk, it is essential to have a detailed diagnostic investigation, which aims at both avoiding an intempestive or inadequate therapeutics behaviour and reducing the affection morbimortality. Recently, the videolaparoscopic approach has proved to be more precise when compared to the other diagnostic methods, by direct visualization of the diaphragmatic laceration, allowing its correction by an immediate suture.
Resumo:
The objective of this master’s thesis is to investigate the loss behavior of three-level ANPC inverter and compare it with conventional NPC inverter. The both inverters are controlled with mature space vector modulation strategy. In order to provide the comparison both accurate and detailed enough NPC and ANPC simulation models should be obtained. The similar control model of SVM is utilized for both NPC and ANPC inverter models. The principles of control algorithms, the structure and description of models are clarified. The power loss calculation model is based on practical calculation approaches with certain assumptions. The comparison between NPC and ANPC topologies is presented based on results obtained for each semiconductor device, their switching and conduction losses and efficiency of the inverters. Alternative switching states of ANPC topology allow distributing losses among the switches more evenly, than in NPC inverter. Obviously, the losses of a switching device depend on its position in the topology. Losses distribution among the components in ANPC topology allows reducing the stress on certain switches, thus losses are equally distributed among the semiconductors, however the efficiency of the inverters is the same. As a new contribution to earlier studies, the obtained models of SVM control, NPC and ANPC inverters have been built. Thus, this thesis can be used in further more complicated modelling of full-power converters for modern multi-megawatt wind energy conversion systems.
Resumo:
Prostate-specific antigen (PSA) is a marker that is commonly used in estimating prostate cancer risk. Prostate cancer is usually a slowly progressing disease, which might not cause any symptoms whatsoever. Nevertheless, some cases of cancer are aggressive and need to be treated before they become life-threatening. However, the blood PSA concentration may rise also in benign prostate diseases and using a single total PSA (tPSA) measurement to guide the decision on further examinations leads to many unnecessary biopsies, over-detection, and overtreatment of indolent cancers which would not require treatment. Therefore, there is a need for markers that would better separate cancer from benign disorders, and would also predict cancer aggressiveness. The aim of this study was to evaluate whether intact and nicked forms of free PSA (fPSA-I and fPSA-N) or human kallikrein-related peptidase 2 (hK2) could serve as new tools in estimating prostate cancer risk. First, the immunoassays for fPSA-I and free and total hK2 were optimized so that they would be less prone to assay interference caused by interfering factors present in some blood samples. The optimized assays were shown to work well and were used to study the marker concentrations in the clinical sample panels. The marker levels were measured from preoperative blood samples of prostate cancer patients scheduled for radical prostatectomy. The association of the markers with the cancer stage and grade was studied. It was found that among all tested markers and their combinations especially the ratio of fPSA-N to tPSA and ratio of free PSA (fPSA) to tPSA were associated with both cancer stage and grade. They might be useful in predicting the cancer aggressiveness, but further follow-up studies are necessary to fully evaluate the significance of the markers in this clinical setting. The markers tPSA, fPSA, fPSA-I and hK2 were combined in a statistical model which was previously shown to be able to reduce unnecessary biopsies when applied to large screening cohorts of men with elevated tPSA. The discriminative accuracy of this model was compared to models based on established clinical predictors in reference to biopsy outcome. The kallikrein model and the calculated fPSA-N concentrations (fPSA minus fPSA-I) correlated with the prostate volume and the model, when compared to the clinical models, predicted prostate cancer in biopsy equally well. Hence, the measurement of kallikreins in a blood sample could be used to replace the volume measurement which is time-consuming, needs instrumentation and skilled personnel and is an uncomfortable procedure. Overall, the model could simplify the estimation of prostate cancer risk. Finally, as the fPSA-N seems to be an interesting new marker, a direct immunoassay for measuring fPSA-N concentrations was developed. The analytical performance was acceptable, but the rather complicated assay protocol needs to be improved until it can be used for measuring large sample panels.
Resumo:
The authors report a case of acute gastric volvulus in a 20-year-old male, complicated by perforation near the gastroesophageal junction and generalized peritonitis. This is an uncommon and potentially lethal conditon although our patient has been handled successfully with a partial gastrectomy.