Gastroesophageal reflux episodes in asthmatic patients and their temporal relation with sleep architecture

Gastroesophageal reflux (GER) is common in asthma patients and can contribute to sleep disruption. The aim of the present study was to determine the time-related distribution of GER events together with their impact on sleep in asthmatic subjects with GER disease symptoms. The inclusion criteria were: 18-65 years, controlled moderate to severe asthma and GER-compatible clinical evidence. The exclusion criteria were: chronic obstructive lung disease, smoking, infections of the upper airways, use of oral corticosteroids, other co-morbidities, pregnancy, sleep-related disorders, night-time shift work, and the use of substances with impact on sleep. Asthmatic patients with nocturnal symptoms were excluded. All-night polysomnography and esophageal pH monitoring were recorded simultaneously. Of the 147 subjects selected, 31 patients and 31 controls were included. Seventeen patients were classified as DeMeester positive and 14 as DeMeester negative. Both groups displayed similar outcomes when general variables were considered. Sleep stage modification one minute prior to GER was observed in the DeMeester-positive group. Awakening was the most frequent occurrence at GER onset and during the 1-min period preceding 38% of the nocturnal GER. Sleep stage 2 was also prevalent and preceded 36% of GER events. In the DeMeester-negative group, awakening was the most frequent response before and during GER. Modifications in sleep stages, arousals or awakenings were associated with 75% of the total GER events analyzed during the period of one minute before and after the fall of esophageal pH below 4 in the DeMeester-positive group. These data provide evidence that sleep modifications precede the GER events in asthmatic patients.

How Lean Six Sigma and Agile principles optimize ITIL-based processes

Imagine the potential implications of an organization whose business and IT processes are well aligned and are capable of reactively and proactively responding to the external and internal changes. The Philips IT Infrastructure and Operations department (I&O) is undergoing a series of transformation activities to help Philips business keeping up with the changes. I&O would serve a critical function in any business sectors; given that the I&O’s strategy switched from “design, build and run” to “specify, acquire and performance manage”, that function is amplified. In 2013, I&O’s biggest transforming programme I&O Futures engaged multiple interdisciplinary departments and programs on decommissioning legacy processes and restructuring new processes with respect to the Information Technology Internet Library (ITIL), helping I&O to achieve a common infrastructure and operating platform (CI&OP). The author joined I&O Futures in the early 2014 and contributed to the CI&OP release 1, during which a designed model Bing Box and its evaluations were conducted through the lens of six sigma’s structured define-measure-analyze-improve-control (DMAIC) improvement approach. This Bing Box model was intended to firstly combine business and IT principles, namely Lean IT, Agile, ITIL best practices, and Aspect-oriented programming (AOP) into a framework. Secondly, the author implemented the modularized optimization cycles according to the defined framework into Philips’ ITIL-based processes and, subsequently, to enhance business process performance as well as to increase efficiency of the optimization cycles. The unique of this thesis is that the Bing Box model not only provided comprehensive optimization approaches and principles for business process performance, but also integrated and standardized optimization modules for the optimization process itself. The research followed a design research guideline that seek to extend the boundaries of human and organizational capabilities by creating new and innovative artifacts. The Chapter 2 firstly reviewed the current research on Lean Six Sigma, Agile, AOP and ITIL, aiming at identifying the broad conceptual bases for this study. In Chapter 3, we included the process of constructing the Bing Box model. The Chapter 4 described the adoption of Bing Box model: two-implementation case validated by stakeholders through observations and interviews. Chapter 5 contained the concluding remarks, the limitation of this research work and the future research areas. Chapter 6 provided the references used in this thesis.

Talkootyön verokohtelu

Tutkimus käsittelee talkootyön verotusta, joka liittyy lähinnä aatteellisten yhdistysten toimintaan. Tutkimuksen tavoitteena on muodostaa selkeä kokonaiskuva talkootyön verokohtelusta sekä osoittaa oikeustapauksiin perehtymällä mahdollisia riskitekijöitä yhdistysten kannalta kielteisiin veroseuraamuksiin. Tutkimusmenetelmä on lainopillinen eli voimassa olevaa oikeutta tutkiva. Työn teoreettisen viitekehyksen muodostavat siten lainsäädäntö, oikeuskirjallisuus sekä Verohallinnon ohjeistus, jolla on ennakkopäätösten ohella suuri käytännön merkitys verotuksessa. Yhdistystoiminnan perusta on vapaaehtoistyövoima. Välitön, vastikkeeton työ suoraan yhdistyksen hyväksi on verotuksellisesti ongelmaton. Talkootyösuoritteet eli välillinen työ yhdistyksen nimissä kolmannen osapuolen lukuun muodostavat merkittävän osuuden yhdistysten varainhankinnasta. Talkootyötulo voi olla verotonta ainoastaan, mikäli korvauksen saaja täyttää tuloverolaissa mainitut yleishyödyllisyyskriteerit. Lisäksi verottomuuden edellytyksenä on se, ettei suoritusta pidetä yhdistyksen elinkeinotulona tai työn tekijän henkilökohtaisena palkkana. Saatu tulo on käytettävä yhdistyksen tarkoituksen mukaiseen yleishyödylliseen toimintaan, eikä hyöty saa kanavoitua työn tekijöiden hyväksi. Oikeustapausten perusteella talkootyön verollisuutta arvioitaessa merkitystä on annettu työn kestolle, toimeksiantajan johdon ja valvonnan olemassaololle, työn läheiselle liittymiselle varsinaiseen yleishyödylliseen toimintaan, kilpailuolosuhteille sekä tulojen määrälle suhteessa muihin tuloihin. Ratkaisujen valossa verotuskäytäntö vaikuttaa osittain ristiriitaiselta. Lisäksi on muistettava, että kyseessä on aina yksittäistapauksen kokonaisarviointi. Riskialttiilta vaikuttavassa tapauksessa verovelvollisen on suositeltavaa hakea ennakkokannanotto, sillä usean vuoden ajalta kumuloituvat veroseuraamukset johtavat helposti syvään talousahdinkoon, pahimmillaan jopa toiminnan lakkaamiseen.

Ethical leadership as a way to promote work-related well-being

The purpose of this study was to clarify the connections of ethical leadership with the work-related well-being of employees. Additionally, the role of occupational health care in ethical leadership that promotes work-related well- being was analyzed. The objective of the study was to produce knowledge to support the development of ethical leadership and work-related well-being as well as to find ways for occupational health care to support organizations in these actions. The target groups of this study consisted of the managers (N=43) and employees (N=336) working in one organization in the Finnish energy industry. The population was studied in November 2014 using census. The data was gathered with two different web-based surveys containing structured and open questions. The survey for managers consisted of background questions and statements concerning ethical leadership, work-related well-being and occupational health care. The employee questionnaire consisted of questions about background and statements about work-related well-being and ethical leadership. The structured questions were analyzed with SPSS Statistical Program and the open questions using inductive content analysis. At least 80 % of the managers saw their actions as ethical in all but one part of ethical leadership. The work-related well-being of the employees was found best in the area of ability to work (91 % agreed) and lowest in the area of experience of ethical leadership (67 % agreed). The results showed a strong positive connection between ethical leadership and all the components of work- related well-being. The managers and employees were generally quite happy with the services of occupational health care but managers saw some problems with the collaboration with occupational health care. Several ways to improve work-related well-being and collaboration with occupational health care were found. One of the most important things was thought to be offering ways to maintain ability to work and making these actions visible. Investing in ethical leadership and work-related well-being is extremely important for the success of an organization and the societal benefits cannot be forgotten either. The role of occupational health care in promoting the health and well-being of employees is substantial. Occupational health care should offer managers more tools to recognize difficult situations and acting in them as well as encourage managers to seek help from occupational health care without hesitation in problematic situations of leadership.

Ethical leadership as a way to promote work-related well-being

The purpose of this study was to clarify the connections of ethical leadership with the work-related well-being of employees. Additionally, the role of occupational health care in ethical leadership that promotes work-related well- being was analyzed. The objective of the study was to produce knowledge to support the development of ethical leadership and work-related well-being as well as to find ways for occupational health care to support organizations in these actions. The target groups of this study consisted of the managers (N=43) and employees (N=336) working in one organization in the Finnish energy industry. The population was studied in November 2014 using census. The data was gathered with two different web-based surveys containing structured and open questions. The survey for managers consisted of background questions and statements concerning ethical leadership, work-related well-being and occupational health care. The employee questionnaire consisted of questions about background and statements about work-related well-being and ethical leadership. The structured questions were analyzed with SPSS Statistical Program and the open questions using inductive content analysis. At least 80 % of the managers saw their actions as ethical in all but one part of ethical leadership. The work-related well-being of the employees was found best in the area of ability to work (91 % agreed) and lowest in the area of experience of ethical leadership (67 % agreed). The results showed a strong positive connection between ethical leadership and all the components of work- related well-being. The managers and employees were generally quite happy with the services of occupational health care but managers saw some problems with the collaboration with occupational health care. Several ways to improve work-related well-being and collaboration with occupational health care were found. One of the most important things was thought to be offering ways to maintain ability to work and making these actions visible. Investing in ethical leadership and work-related well-being is extremely important for the success of an organization and the societal benefits cannot be forgotten either. The role of occupational health care in promoting the health and well-being of employees is substantial. Occupational health care should offer managers more tools to recognize difficult situations and acting in them as well as encourage managers to seek help from occupational health care without hesitation in problematic situations of leadership.

Academics as parents--parents as academics : a study of the integration of intellectual and child-care labours /

Discussions concerning the challenges of combining work and family are certainly not new, and still actively continue. There is, however, a silence in the related literature regarding a comprehensive description of integrating specifically university academic ~. work and family responsibilities. This silence is especially evident for men who are parents as well as academics. With the participation of 4 key informants, this qualitative research study gave voice to men and women who participate in the academic labour of a Canadian university as professors, and as graduate students, along with the parenting labour of at least 1 child under the age of7. Methodology was developed to reveal in-depth perspectives regarding the work practices employed by 4 key informants as they combined intellectual and child-care responsibilities. Multiple data collection methods included journal reflections, day time observation sessions, a focus group, and a final evaluation questionnaire. Using research findings, together with information extrapolated from Three Models of the Family (Eichler, 1997), this study also took steps toward developing a Proposed "Three Models of the University," to offer explanation for the work practices of the key informants as academics/parents, and also for future consideration in university policy formation.

The landscape of work engagement in brain injury rehabilitation /

This study examined work engagement among brain injury rehabilitation professionals with specific attention to how they engage with their work (the extent to which they experience vigor, dedication, and absorption while working) and how they engage with people (the degree to which they are welcoming towards others and demonstrate integrity, responsibility, transparency). This study also tested a theoretical model of work engagement that predicted a relationship between engagement and personal, interpersonal, and organizational capacity. Eighty-one staff employed in a hospital-based brain injury program participated in the study. A quantitative self-report survey was used to measure participants' levels of capacity and engagement and a qualitative question was included to identify initiatives that could be introduced to enhance job performance. As predicted by the model, there were statistically significant positive correlations among all three capacity variables and engagement with work and statistically significant positive correlations between ethical engagement and personal and interpersonal capacity. The results of the qualitative data analysis revealed three broad categories of recommendations for improving job performance (more learning opportunities, more resources to support professional development, and the need to build greater team cohesion). These findings provide initial support for a theoretical model that emphasizes the link between capacity and engagement, which could be used to guide theory-driven interventions aimed at improving the work environment.

An examination of learning resulting from a transition from a directed to a self-directed work environment

~ This study focuses on the process of self-directed learning that individuals go through as they adapt to new work situations. This is a study of how one critical incident, specifically the transition from a traditional office structure to a home office structure, affected employees and what their learning process was as they adapted to the new environment. This study has 3 educational foundations: adult learning, self-directed learning, and the social context from which the learning will occur. Six women and 2 men were interviewed approximately 1 year following the transition. Analysis of the data revealed 5 themes of: impacts of the self-directed environment on participants' personal lives, their roles, skill set, productivity, and the physical environment; support offered by the organization, family, and office administration; personal development, specific learning needs, and personal skills; boundaries as they relate to family and work; and skill set and orientation requirements of new home office employees. The findings revealed the learning processes of the 8 participants. The learning processes of these participants were discussed within a theoretical framework of the learners, their immediate surroundings, and the larger social environment. The results indicated that the transition from a directed work environment to a self directed work environment is a complex, interrelated process. An element found throughout the theoretical framework is that of control. A second critical element is the need for participants to have a clearly defined work role and an opportunity to engage in discussion with peers and the community. Further findings reinforced the importance of climate and found that the physical environment is a key factor in a successful selfdirected work environment. The findings of this study revealed that no one factor makes an individual function successfully in a self-directed work environment, but that it is a complex interplay among the leamer, their immediate surroundings, and the social environment that will have the greatest impact on success. Recommendations are made which can be used to guide organizational leaders in facilitating employees' transition from a directed to a self-directed work environment. Additionally, recommendations are made for further research in the area of self-directed work environments.

A Study of role conflict, role ambiguity, locus of control, job satisfaction and participation in decision making among front-line vocational service workers for mentally retarded adults

This study was an investigation of individual and organizational factors, as perceived by front-line vocational service workers from Adult Rehabilitation Centres (ARC Industries) for mentally retarded adults. The specific variables which were measured included role conflict/role ambiguity (role factors), internal/external locus of control (individual differences), job satisfaction with work and supervision (job attitudes) and participation in deci~ion making (organizational factor). The exploration of these constructs was conducted by means of self-report questionnaires which were completed by sixty-nine out of a total of ninety front-line employees. The surveys were distributed in booklet form to nine distinct rehabilitation facilities from St. Catharines, West Lincoln, Greater Niagara, Port Colborne, WeIland, Fort Erie, Hamilton, Guelph and Brantford. The survey data was evaluated by the statisti.cal Package for the Social Sciences (SPSS) which used the Pearson Product Moment Correlation procedure and a compar~son of means test. A comparison of correlation coefficients test was also conducted. This statistical procedure was calculated mathematically. The results obtained from the statistical evaluation confirmed the prediction that self-reported measures of participation in decision making and satisfaction (work and supervision) would be negatively correlated with role conflict and role ambiguity. As well, the speculation that perceived satisfaction (work and supervision) would be positively correlated with participation in decision making was empirically supported. Internal and external locus of control did not contribute to a significant difference in r~sponses to role perceptions (conflict and ambiguity) , satisfaction (work and supervision) or the correlational relationship between participation in decision making and satisfaction (work and supervision). Overall, the findings from this study substantiated the importance of examining employee perceptions in the workplace and the interrelationships among individual and organizational variables. This research was considered a contribution to the general area of occupational stress and to the study of individuals in work organizations.

Job satisfaction among nurses and its relationship to reflective practice /

This study was undertaken to explore job satisfaction among nurses and its relationship to reflective practice. It is a qualitative study that listens to the perspectives of 7 mental health nurses who work In a conmiunity hospital in southern Ontario. A pilot survey was conducted prior to the face-to -face interviews in order to develop meaningful questions to utilize in the interviews. Nurses participating in the study were ensured anonjnnlty and an opportunity to have their own personal perspectives heard. A convenient sample was obtained from the hospital in which the researcher worked as an educator and professional practice consultant. The concept of job satisfaction was found to be driven by the desire to do important work and to make a difference in patients' lives. The nurses articulated that it is directly related to other factors, such as the opportunity to work in one's area, of preference, involvement in decisionmaking processes, better patient/ staff ratios, and affordable, accessible continuing educational opportunities. Those nurses who have embraced reflective practice for many years seem to be able to sort out that which drives them to stay in nursing and that which will influence them to leave. The constraints of the study cO-e that it is a small qualitative study; therefore, the results are not generallzable. Reflection is integral to the practice of mental heallth nursing find a tool that is used extensively in therapy with patients. Future research could involve studing a different group of nurses who may be more task focused than mental health nurses.

A Foucauldian Analysis of Power and Representation in an Attempt to Run a Photovoice Project with Youth

This project evolved out of a search for ways to conduct research on “others” in a way that does not exploit, stigmatize or misrepresent their experience. This thesis is an ethnographic study in leisure research and youth work and an experiment in running a photovoice project. Photovoice is a participatory visual method that embodies the emancipatory ideal of empowering others through self-representation. The literature on photovoice lacks a comprehensive discussion on the complexity of power and representation. Postmodern theorists have proposed that participatory methods are not benign and that initiatives are acts of power in themselves that produce effects (Cook & Kothari, 2001). A Foucauldian analysis of power is used to deconstruct the researcher’s practice and reflect on why and how youth are “engaged”. This project seeks to embrace the principle of working “with” others, but also work from a postmodern perspective that acknowledges power and representation as ongoing problems.

The Implementations of Professional Learning Communities (PLCs) in Beijing and Ontario Schools

Since the knowledge-based economy has become a fashion over the last few decades, the concept of the professional learning community (PLC) has started being accepted by educational institutions and governments as an effective framework to improve teachers’ collective work and collaboration. The purpose of this research was to compare and contrast the implementations of PLCs between Beijing schools and Ontario schools from principals’ personal narratives. In order to discover the lessons and widen the scope to understand the PLC, this research applied qualitative design to collect the data from two principal participants in each location by semistructured interviews. Four themes emerged: (a) structure and technology, (b) identity and climate, (c) task and support, and (d) change and challenge. This research found that the root of the characteristics of the PLCs in Beijing and Ontario was the different existing teaching and learning systems as well as the test systems. Teaching Research Groups (TRGs) is one of the systems that help Chinese to organize routine time and input resources to improve teachers’ professional development. However, Canadian schools lack a similar system that guarantees the time and resources. Moreover, standardized test plays different roles in China and Canada. In China, standardized tests, such as the college entrance examination, are regarded as the important purpose of education, whereas Ontario principals saw the Education Quality and Accountability Office (EQAO) as a tool rather than a primary purpose. These two main differences influenced principals’ beliefs, attitudes, strategies, and practices. The implications based on this discovery provide new perspectives for principals, teachers, policy makers, and scholars to widen and deepen the research and practice of the PLC.

Convergence of corporate governance : comparative study in Canada and in China

"Mémoire présenté à la Faculté des études supérieures En vue de l'obtention du grade de Maître en droit (LL.M.)"

Macrobius, the classical paideia, and table etiquette c. 420 CE : a commentary on the Saturnalia 7.1-3

Ce mémoire traite des Saturnales de Macrobe, haut fonctionnaire du 5ième siècle après J.C. et encyclopédiste latin. Malgré l’opinion reçue, selon laquelle les Saturnales dépendraient presque exclusivement d’un nombre très restreint de sources, souvent copiées mot à mot, on a reconnu depuis longtemps que Macrobe remanie de son propre chef l’une de ces sources, les Propos de Table de Plutarque, dans son septième livre. Ce mémoire démontre que ce modèle, tout comme les sources mineures, latines et grecques, avec lesquelles Macrobe le complète, lui était assez familier pour servir à l’articulation d’une vision propre; les Saturnales ne peuvent donc être cités comme preuve de la décadence de leur époque. Ce mémoire fournit une traduction et un commentaire des chapitres 7.1-3 des Saturnales, avec une explication de leurs rapports avec les Propos de Table 1.1 et 2.1 de Plutarque ainsi que des éléments propre à Macrobe, afin de reconstruire sa méthode de composition et de déterminer ses attentes par rapport à son lecteur de l’empire tardif. Le commentaire est précédé d’une introduction de l’auteur, de l’œuvre, et du septième livre.

Significations et perceptions en architecture dans l’œuvre de Christian Norberg-Schulz

L’architecture au sens strict, qui renvoie à la construction, n’est pas indépendante des déterminations mentales, des images et des valeurs esthétiques, comme références, amenées par divers champs d’intérêt au problème du sens. Elle est, de par ce fait, un objet d’interprétation. Ce qu’on appelle communément « signification architecturale », est un univers vaste dans lequel sont constellées des constructions hypothétiques. En ce qui nous concerne, il s’agit non seulement de mouler la signification architecturale selon un cadre et des matières spécifiques de référence, mais aussi, de voir de près la relation de cette question avec l’attitude de perception de l’homme. Dans l’étude de la signification architecturale, on ne peut donc se détacher du problème de la perception. Au fond, notre travail montrera leur interaction, les moyens de sa mise en œuvre et ce qui est en jeu selon les pratiques théoriques qui la commandent. En posant la question de l’origine de l’acte de perception, qui n’est ni un simple acte de voir, ni un acte contemplatif, mais une forme d’interaction active avec la forme architecturale ou la forme d’art en général, on trouve dans les écrits de l’historien Christian Norberg-Schulz deux types de travaux, et donc deux types de réponses dont nous pouvons d’emblée souligner le caractère antinomique l’une par rapport à l’autre. C’est qu’il traite, dans le premier livre qu’il a écrit, Intentions in architecture (1962), connu dans sa version française sous le titre Système logique de l’architecture (1974, ci-après SLA), de l’expression architecturale et des modes de vie en société comme un continuum, défendant ainsi une approche culturelle de la question en jeu : la signification architecturale et ses temporalités. SLA désigne et représente un système théorique influencé, à bien des égards, par les travaux de l’épistémologie de Jean Piaget et par les contributions de la sémiotique au développement de l’étude de la signification architecturale. Le second type de réponse sur l’origine de l’acte de perception que formule Norberg-Schulz, basé sur sur les réflexions du philosophe Martin Heidegger, se rapporte à un terrain d’étude qui se situe à la dérive de la revendication du fondement social et culturel du langage architectural. Il lie, plus précisément, l’étude de la signification à l’étude de l’être. Reconnaissant ainsi la primauté, voire la prééminence, d’une recherche ontologique, qui consiste à soutenir les questionnements sur l’être en tant qu’être, il devrait amener avec régularité, à partir de son livre Existence, Space and Architecture (1971), des questions sur le fondement universel et historique de l’expression architecturale. Aux deux mouvements théoriques caractéristiques de ses écrits correspond le mouvement que prend la construction de notre thèse que nous séparons en deux parties. La première partie sera ainsi consacrée à l’étude de SLA avec l’objectif de déceler les ambiguïtés qui entourent le cadre de son élaboration et à montrer les types de legs que son auteur laisse à la théorie architecturale. Notre étude va montrer l’aspect controversé de ce livre, lié aux influences qu’exerce la pragmatique sur l’étude de la signification. Il s’agit dans cette première partie de présenter les modèles théoriques dont il débat et de les mettre en relation avec les différentes échelles qui y sont proposées pour l’étude du langage architectural, notamment avec l’échelle sociale. Celle-ci implique l’étude de la fonctionnalité de l’architecture et des moyens de recherche sur la typologie de la forme architecturale et sur sa schématisation. Notre approche critique de cet ouvrage prend le point de vue de la recherche historique chez Manfredo Tafuri. La seconde partie de notre thèse porte, elle, sur les fondements de l’intérêt chez Norberg-Schulz à partager avec Heidegger la question de l’Être qui contribuent à fonder une forme d’investigation existentielle sur la signification architecturale et du problème de la perception . L’éclairage de ces fondements exige, toutefois, de montrer l’enracinement de la question de l’Être dans l’essence de la pratique herméneutique chez Heidegger, mais aussi chez H. G. Gadamer, dont se réclame aussi directement Norberg-Schulz, et de dévoiler, par conséquent, la primauté établie de l’image comme champ permettant d’instaurer la question de l’Être au sein de la recherche architecturale. Sa recherche conséquente sur des valeurs esthétiques transculturelles a ainsi permis de réduire les échelles d’étude de la signification à l’unique échelle d’étude de l’Être. C’est en empruntant cette direction que Norberg-Schulz constitue, au fond, suivant Heidegger, une approche qui a pour tâche d’aborder l’« habiter » et le « bâtir » à titre de solutions au problème existentiel de l’Être. Notre étude révèle, cependant, une interaction entre la question de l’Être et la critique de la technique moderne par laquelle l’architecture est directement concernée, centrée sur son attrait le plus marquant : la reproductibilité des formes. Entre les écrits de Norberg-Schulz et les analyses spécifiques de Heidegger sur le problème de l’art, il existe un contexte de rupture avec le langage de la théorie qu’il s’agit pour nous de dégager et de ramener aux exigences du travail herméneutique, une approche que nous avons nous-même adoptée. Notre méthode est donc essentiellement qualitative. Elle s’inspire notamment des méthodes d’interprétation, de là aussi notre recours à un corpus constitué des travaux de Gilles Deleuze et de Jacques Derrida ainsi qu’à d’autres travaux associés à ce type d’analyse. Notre recherche demeure cependant attentive à des questions d’ordre épistémologique concernant la relation entre la discipline architecturale et les sciences qui se prêtent à l’étude du langage architectural. Notre thèse propose non seulement une compréhension approfondie des réflexions de Norberg-Schulz, mais aussi une démonstration de l’incompatibilité de la phénoménologie de Heidegger et des sciences du langage, notamment la sémiotique.