964 resultados para Add-06_4


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The several transition processes happening throughout lije are periods of constant adaptations. Each transition process requires making decisions affecting in greater or a lesser degree all the aspects of the persono The vital course development embraces different transition realms. In this paper, we pay particular attention to the academic and occupational itineraries. The academic transitions have to facilitate the curriculum continuity between cycles or academic stages and the adaptation to new levels. In the professional world, two essential transitions arestanding out: socio-professional insertion and retirement. To those one should add occupational transitions - voluntary or not -, which are nowadays increasingly present in the labour market. In each of these processes, a guiding intervention is needed providing strategies for personal development and at the same time generating social integration

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The university should add to the scientific and technical education of the students, the development of the so-called generic competences. They are cognitive, social, emotional and ethical (initiative, effort for quality, responsibility, etc.) competences which have a transferable condition and they constitute the " knowing of how to be" in the professional education of the university student. A structured proposal of the generic competences that could be included in the educative university action is presented. There is a description of the design and application of a question paper made to the students of the last course of Business Studies and their teachers to know not only the perception that the students have about the possession of generic competences, but also the valuation of students and teachers about the different generic competences for the professional profile of qualified people as well as the contribution of universities to the development or improvement of such competences. The data is analysed and checked, conclusions are extracted and action strategies are suggested

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Tutkielman tavoitteena oli etsiä PK-yrittäjien reagointitapoja markkinariskiin va¬rautumiseen. Tutkielman teoriaosa jakautui kahteen osaan, jossa ensimmäisessä osassa haettiin markkinariskeille alttiita yrityksen kasvukohtia. Teorian toisessa osassa etsittiin teoriasta reagointitapoja suhteessa markkinariskeihin. Tutkimusmenetelmäksi valittiin teemahaastattelu. Tutkimusaineisto koostui Ky¬menlaakson alueen eri toimialan PK-yrittäjän haastattelusta. Haastattelun teemoina olivat korko-, valuutta- ja hyödykehintariski. Edellä mainittuja teemoja käsi¬teltiin yrityksen oston, varastoinnin ja myynnin näkökulmista. Kahdeksan yrittäjän haastattelujen lisäksi haastateltiin kolmea pankissa toimivaa asiakasvastuullista johtajaa tai neuvojaa. Asiakasvastuullisten haastattelujen tarkoituksena oli saada tutkimuksen analysointiin myös rahoittajan näkökulma. Kerätty haastatteluaineisto analysoitiin kvalitatiivisin menetelmin. Tutkielmassa havaittiin PK-yrittäjien käyttävän hyödykseen teoriamalleja eniten korkoriskin hallintaan. Valuutta- ja hyödykehintariskeihin ei tutkielman mukaan esitellyt teoriat soveltuneet vaan niihin yrittäjät pyrkivät varautumaan käytännössä muilla keinoilla.

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Breast cancer is the most common diagnosed cancer and the leading cause of cancer death among females worldwide. It is considered a highly heterogeneous disease and it must be classified into more homogeneous groups. Hence, the purpose of this study was to classify breast tumors based on variations in gene expression patterns derived from RNA sequencing by using different class discovery methods. 42 breast tumors paired-samples were sequenced by Illumine Genome Analyzer and the data was analyzed and prepared by TopHat2 and htseq-count. As reported previously, breast cancer could be grouped into five main groups known as basal epithelial-like group, HER2 group, normal breast-like group and two Luminal groups with a distinctive expression profile. Classifying breast tumor samples by using PAM50 method, the most common subtype was Luminal B and was significantly associated with ESR1 and ERBB2 high expression. Luminal A subtype had ESR1 and SLC39A6 significant high expression, whereas HER2 subtype had a high expression of ERBB2 and CNNE1 genes and low luminal epithelial gene expression. Basal-like and normal-like subtypes were associated with low expression of ESR1, PgR and HER2, and had significant high expression of cytokeratins 5 and 17. Our results were similar compared with TGCA breast cancer data results and with known studies related with breast cancer classification. Classifying breast tumors could add significant prognostic and predictive information to standard parameters, and moreover, identify marker genes for each subtype to find a better therapy for patients with breast cancer.

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Tutkimuksen lähtökohtana oli selvittää, voidaanko viilun valmistusprosessiin liittää uusi työvaihe, viilun esikuivaus. Esikuivauksen tarkoituksena on poistaa kosteutta viiluista ennen varsinaista kuivausta ja lisätä näin kuivauskapasiteettia. Tehdyissä tutkimuksissa viilut esikuivattiin nipuissa puristamalla. Muuttujina esikuivauksessa toimivat puristusaika ja -paine. Niiden määrittelyn lähtökohtana pidettiin sitä, etteivät viilun ominaisuudet saa merkittävästi heikentyä esikuivauksen aikana ja samalla viiluista on saatava mahdollisimman paljon kosteutta pois. Aikaisempien tutkimusten avulla selvitettiin vanerin valmistuksen, viilun kuivauksen sekä viilun esikuivauksen teoriaa. Lisäksi selvitettiin puun ominaisuuksien antamia mahdollisuuksia ja rajoitteita esikuivaukseen liittyen. Tutkimus koostui kahdesta osasta: laboratorio- ja tehdastutkimuksista. Laboratoriotutkimuksen tarkoituksena oli toimia tehdastutkimuksen esitutkimuksena. Laboratoriotutkimuksessa tutkittiin ainoastaan esikuivauksen vaikutusta märille viiluille. Tehdastutkimusosiossa esikuivatuista viiluista valmistettiin normaalin vanerinvalmistusprosessin kautta levyjä, joiden ominaisuuksia verrattiin normaaleista viiluista valmistettuihin vanereihin. Viilujen esikuivauksen todettiin pienentävän kuusiviilujen kosteuspitoisuutta. Tämän lisäksi kosteuspitoisuuden muutokset esikuivauksen aikana tapahtuivat tasaisesti niin yksittäisen viilun kuin viilunipunkin sisällä. Esikuivatuista viiluista valmistetut vanerilevyt täyttivät kaikki standardien sekä vanerin laadunvalvontasopimuksen asettamat vaatimukset. Esikuivauksen haitaksi tutkimuksissa todettiin viilun paksuuden pienentymä. Ennen esikuivauksen soveltamista teolliseen käyttöön nähtiin tarvetta lisätutkimukselle, jossa tulisi selvittää suurempien viilunippukokojen esikuivaamista sekä niiden varsinaista kuivaamista heti esikuivauksen jälkeen.

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Open Innovation is a relatively new concept which involves a change of paradigm in the R+D+i processes of companies whose aim is to create new technologies or new processes. If to this change, we add the need for innovation in the new green and sustainability economy, and we set out to create a collaborative platform with a learning space where this can happen, we will be facing an overwhelming challenge which requires the application of intelligent programming technologies and languages at the service of education.The aim of the Green IDI (Green Open Innovation) ¿ Economic development and job creation vector in SMEs, based on the environment and sustainability project is to create a platform where companies and individual researchers can perform open innovation processes in the field of sustainability and the environment.The Green IDI (Green Open Innovation) project is funded under the program INNPACTO by the Ministry of Science and Innovation of Spain and is being developed through a consortium formed by the following institutions: GRUPO ICA; COMPARTIA; GRUPO INTERCOM; CETAQUA and the Instituto de Investigación en Inteligencia Artificial (IIIA) from Consejo Superior de Investigaciones Científicas (CSIC). Also the consortium include FUNDACIÓ PRIVADA BARCELONA DIGITAL; PIMEC and UNIVERSITAT OBERTA DE CATALUNYA (UOC).Sustainability and positive action for the environment are considered the principle vector of economic development for companies. As Nicolás Scoli says (2007) ¿in short, preventing unnecessary consumption and the efficient consumption of resources means producing greater wealth with less. Both effects lead to reduced pollution linked to production and consumption¿.The Spanish Sustainable Development Strategy (EEDS) plan defends consumption and sustainable production linked to social and economic development by adhering to the commitment not to endanger ecosystems and abolishing the idea that economic growth is directly proportional to the deterioration of the environment.Uniting the Open Innovation and New Green Economy concepts leads to the "Green Open Innovation¿ Platform creation project.This article analyses the concept of open innovation and defines the importance of the new green and sustainable economy. Lastly, it proposes the creation of eLab. The eLab is defined as an Open Green Innovation Platform personal and collaborative education space which is fed by the interactions of users and which enables innovation processes based on new green economy concepts to be carried out.The creation of a personal learning environment such as eLab on the Green Open Innovation Platform meets the need to offer a collaborative space where platform users can improve their skills regarding the environment and sustainability based on collaborative synergies through Information and Communication Technologies.

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The Gulf of Finland is said to be one of the densest operated sea areas in the world. It is a shallow and economically vulnerable sea area with dense passenger and cargo traffic of which petroleum transports have a share of over 50 %. The winter conditions add to the risks of maritime traffic in the Gulf of Finland. It is widely believed that the growth of maritime transportation will continue also in the future. The Gulf of Finland is surrounded by three very different national economies with, different maritime transportation structures. Finland is a country of high GDP/per capita with a diversified economic structure. The number of ports is large and the maritime transportation consists of many types of cargoes: raw materials, industrial products, consumer goods, coal and petroleum products, and the Russian transit traffic of e.g. new cars and consumer goods. Russia is a large country with huge growth potential; in recent years, the expansion of petroleum exports has lead to a strong economic growth, which is also apparent in the growth of maritime transports. Russia has been expanding its port activities in the Gulf of Finland and it is officially aiming to transport its own imports and exports through the Russian ports in the future; now they are being transported to great extend through the Finnish, Estonian and other Baltic ports. Russia has five ports in the Gulf of Finland. Estonia has also experienced fast economic growth, but the growth has been slowing down already during the past couples of years. The size of its economy is small compared to Russia, which means the transported tonnes cannot be very massive. However, relatively large amounts of the Russian petroleum exports have been transported through the Estonian ports. The future of the Russian transit traffic in Estonia looks nevertheless uncertain and it remains to be seen how it will develop and if Estonia is able to find replacing cargoes if the Russian transit traffic will come to an end in the Estonian ports. Estonia’s own import and export consists of forestry products, metals or other raw materials and consumer goods. Estonia has many ports on the shores of the Gulf of Finland, but the port of Tallinn dominates the cargo volumes. In 2007, 263 M tonnes of cargoes were transported in the maritime traffic in the Gulf of Finland, of which the share of petroleum products was 56 %. 23 % of the cargoes were loaded or unloaded in the Finnish ports, 60 % in the Russian ports and 17 % in the Estonian ports. The largest ports were Primorsk (74.2 M tonnes) St. Petersburg (59.5 M tonnes), Tallinn (35.9 M tonnes), Sköldvik (19.8 M tonnes), Vysotsk (16.5 M tonnes) and Helsinki (13.4 M) tonnes. Approximately 53 600 ship calls were made in the ports of the Gulf of Finland. The densest traffic was found in the ports of St. Petersburg (14 651 ship calls), Helsinki (11 727 ship calls) and Tallinn (10 614 ship calls) in 2007. The transportation scenarios are usually based on the assumption that the amount of transports follows the development of the economy, although also other factors influence the development of transportation, e.g. government policy, environmental aspects, and social and behavioural trends. The relationship between the development of transportation and the economy is usually analyzed in terms of the development of GDP and trade. When the GDP grows to a certain level, especially the international transports increase because countries of high GDP produce, consume and thus transport more. An effective transportation system is also a precondition for the economic development. In this study, the following factors were taken into consideration when formulating the future scenarios: maritime transportation in the Gulf of Finland 2007, economic development, development of key industries, development of infrastructure and environmental aspects in relation to maritime transportation. The basic starting points for the three alternative scenarios were: • the slow growth scenario: economic recession • the average growth scenario: economy will recover quickly from current instability • the strong growth scenario: the most optimistic views on development will realize According to the slow growth scenario, the total tonnes for the maritime transportation in the Gulf of Finland would be 322.4 M tonnes in 2015, which would mean a growth of 23 % compared to 2007. In the average growth scenario, the total tonnes were estimated to be 431.6 M tonnes – a growth of 64 %, and in the strong growth scenario 507.2 M tonnes – a growth of 93%. These tonnes were further divided into petroleum products and other cargoes by country, into export, import and domestic traffic by country, and between the ports. For petroleum products, the share of crude oil and oil products was estimated and the number of tanker calls in 2015 was calculated for each scenario. However, the future development of maritime transportation in the GoF is dependent on so many societal and economic variables that it is not realistic to predict one exact point estimate value for the cargo tonnes for a certain scenario. Plenty of uncertainty is related both to the degree in which the scenario will come true as well as to the cause-effect relations between the different variables. For these reasons, probability distributions for each scenario were formulated by an expert group. As a result, a range for the total tonnes of each scenario was formulated and they are as follows: the slow growth scenario: 280.8 – 363 M tonnes (expectation value 322.4 M tonnes)

  • the average growth scenario: 404.1 – 465.1 M tonnes (expectation value 431.6 M tonnes)
  • the strong growth scenario: 445.4 – 575.4 M tonnes (expectation value 507.2 M tonnes) Three alternatives scenarios were evaluated to realize most likely with the following probability distribution:
  • the slow growth scenario: 35 %
  • the average growth scenario: 50 %
  • the strong growth scenario: 15 %. In other words, expert group evaluated the average growth scenario to be the most likely to realize, second likely was the slow growth scenario, and the strong growth scenario was evaluated to be the most unlikely to realize. In sum, it can be stated that the development of maritime transportation in the Gulf of Finland is dominated by the development of Russia, because Russia dominates the cargo volumes. Maritime transportation in Finland is expected to be more stable and, in any case, such a growth potential cannot be seen in Finland. The development of maritime transportation in Estonia is rather challenging to forecast at the moment but, on the other hand, the transported tonnes in the Estonian ports are relatively small. The shares of export and import of the maritime transportation are not expected to change radically in the reference period. Petroleum products will dominate the transports also in the future and the share of oil products will probably increase compared to the share of crude oil. In regard to the other cargoes, the transports of raw materials and bulk goods will probably be replaced to some extend by cargoes of high-value, which adds especially to the container transports. But in overall, substantial changes are not expected in the commodity groups transported by sea. The growth potential of the ports concentrates on the Russian ports, especially Primorsk and Ust-Luga, if investments will come true as planned. It is likely that the larger ports do better in the competition than the small ones due to the economies of scale and to the concentration of cargo flows. The average ship sizes will probably grow, but the growth potential is rather limited because of geographical conditions and of the maritime transportation structure in the Gulf of Finland. Climate change and other environmental aspects are becoming more central e.g. in transportation politics. These issues can affect the maritime transportation in the Gulf of Finland through, for instance, strict environmental requirements concerning the emissions from shipping, or the port investments. If environmental requirements raise costs, it can affect the demand of transportation. In the near future, the development of the maritime transportation in the Gulf of Finland is mainly dependent on the current economic instability. If it will lead to a longer lasting recession, the growth of the transported tonnes will slow down. But if the instability does not last long, it can be expected that the economic growth will continue and along with it also the growth of transported tonnes.

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    Background: Trichothiodistrophy (TTD) is a rare autosomal recessive condition that is characterized by a specific congenital hair shaft dysplasia caused by deficiency of sulfur associated with a wide spectrum of multisystem abnormalities. In this article, we study clinical, microscopic, and ultrastructural findings of 20 patients with TTD with the aim to add further insights regarding to this rare condition. Additionally, analyses of our results are compared with those extracted from the literature in order to enhance its comprehensibility. Materials and Methods: Twenty cases of TTD were included: 7 from Mexico and 14 from Spain. Clinical, microscopic, scanning electron microscopy (SEM) studies and X-ray microanalysis (XrMa) were carried out in all of them. Genetic studies were performed in all seven Mexican cases. Patients with xeroderma pigmentosum and xeroderma pigmentosum/TTD-complex were excluded. Results: Cuticular changes and longitudinal crests of the hair shaft were demonstrated. These crests were irregular, disorganized, following the hair longest axis. Hair shaft sulfur deficiency was disposed discontinuously and intermittently rather than uniformly. This severe decrease of sulfur contents was located close to the trichoschisis areas. Only five patients did not show related disturbances. Micro-dolichocephaly was observed in five cases and represented the most frequent facial dysmorphism found. It is also remarkable that all patients with urologic malformations also combined diverse neurologic disorders. Moreover, three Mexican sisters demonstrated the coexistence of scarce pubic vellus hair, developmental delay, onychodystrophy, and maxillar/mandibullar hypoplasia. Conclusions: TTD phenotype has greatly varied from very subtle forms to severe alterations such as neurologic abnormalities, blindness, lamellar ichthyosis and gonadal malformations. Herein, a multisystem study should be performed mandatorily in patients diagnosed with TTD.

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    Background: Trichothiodistrophy (TTD) is a rare autosomal recessive condition that is characterized by a specific congenital hair shaft dysplasia caused by deficiency of sulfur associated with a wide spectrum of multisystem abnormalities. In this article, we study clinical, microscopic, and ultrastructural findings of 20 patients with TTD with the aim to add further insights regarding to this rare condition. Additionally, analyses of our results are compared with those extracted from the literature in order to enhance its comprehensibility. Materials and Methods: Twenty cases of TTD were included: 7 from Mexico and 14 from Spain. Clinical, microscopic, scanning electron microscopy (SEM) studies and X-ray microanalysis (XrMa) were carried out in all of them. Genetic studies were performed in all seven Mexican cases. Patients with xeroderma pigmentosum and xeroderma pigmentosum/TTD-complex were excluded. Results: Cuticular changes and longitudinal crests of the hair shaft were demonstrated. These crests were irregular, disorganized, following the hair longest axis. Hair shaft sulfur deficiency was disposed discontinuously and intermittently rather than uniformly. This severe decrease of sulfur contents was located close to the trichoschisis areas. Only five patients did not show related disturbances. Micro-dolichocephaly was observed in five cases and represented the most frequent facial dysmorphism found. It is also remarkable that all patients with urologic malformations also combined diverse neurologic disorders. Moreover, three Mexican sisters demonstrated the coexistence of scarce pubic vellus hair, developmental delay, onychodystrophy, and maxillar/mandibullar hypoplasia. Conclusions: TTD phenotype has greatly varied from very subtle forms to severe alterations such as neurologic abnormalities, blindness, lamellar ichthyosis and gonadal malformations. Herein, a multisystem study should be performed mandatorily in patients diagnosed with TTD.

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    Several empirical studies have analyzed the factors that influence local privatization. Variables related to fiscal stress, cost reduction, political processes and ideological attitudes are the most common explanatory variables used in these studies. In this paper, we add to this literature by examining the influence of transaction costs and political factors on local governments’ choices through new variables. In addition to this, we consider the role of additional aspects, such as intermunicipal cooperation as a potential alternative to privatization in order to exploit scale economies or scope economies. We consider two relevant services: solid waste collection and water distribution. Results from our estimates show that privatization (that is, contracting out to a private firm) is less common for water distribution than for solid waste collection. Higher transaction costs in water distribution are consistent with this finding. Furthermore, we find that municipalities with a conservative ruling party privatize more often regardless of the ideological orientation of the constituency. This shows that those political interests able to influence local elections are more important in determining the form of delivery than is the basic ideological stance of the constituency. Finally, we find that intermunicipal cooperation is an alternative to local privatization.

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    The Brazilian effort on R&D of products from the national biodiversity dates back to the 70's. The Central de Medicamentos - CEME - was tailored to add scientific and technological competence to the production of pharmaceutical drugs derived from the Brazilian biodiversity by means of the Research Programme on Medicinal Plants - PPPM. Although previous to the Convention on Biological Diversity - CBD - and to the current debate and the ever-growing interest on phytomedicines, CEME has historical importance in the present governmental efforts on fostering the R&D on phytomedicines. This article makes a historical redemption of the PPPM, the actions and the results in the course of its existence.

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    This paper sets out to identify the initial positions of the different decisionmakers who intervene in a group decision making process with a reducednumber of actors, and to establish possible consensus paths between theseactors. As a methodological support, it employs one of the most widely-knownmulticriteria decision techniques, namely, the Analytic Hierarchy Process(AHP). Assuming that the judgements elicited by the decision makers follow theso-called multiplicative model (Crawford and Williams, 1985; Altuzarra et al.,1997; Laininen and Hämäläinen, 2003) with log-normal errors and unknownvariance, a Bayesian approach is used in the estimation of the relative prioritiesof the alternatives being compared. These priorities, estimated by way of themedian of the posterior distribution and normalised in a distributive manner(priorities add up to one), are a clear example of compositional data that will beused in the search for consensus between the actors involved in the resolution ofthe problem through the use of Multidimensional Scaling tools

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    We live in an era of profound changes in university education. The implementation of Bologna plan has led us to raise new teaching methodologies, to review the role of the student, competency assessment, the incorporation of ICT. Unthinkable acts, one or two decade ago. The TIC concept is very broad and is attributed to the media, processes and content usage. Inside the supports and platforms, we stress tools that allow automatic correction of exercises, because they are instruments of great educational value because instantly they assess students and provide instant feedback about the knowledge that they have either as message support or note. If the power of these tools, we add the Internet, using e-learning environment, the results allow us to work, edit, evaluate, resolve doubts, and so on, anywhere, anytime. We present part of a platform and the results of its use in the field of health sciences

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    Aikuispotilaan kotisyntyisen keuhkokuumeen etiologinen diagnostiikka mikrobiologisilla pikamenetelmillä Tausta. Keuhkokuume on vakava sairaus, johon sairastuu Suomessa vuosittain n. 60 000 aikuista. Huolimatta siitä, että taudin hoito on kehittynyt, siihen liittyy yhä merkittävä, 6-15%:n kuolleisuus. Alahengitystieinfektion aiheuttajamikrobien tunnistaminen on myös edelleen haasteellista. Tavoitteet. Tämän työn tavoitteena oli tutkia Turun yliopistollisessa keskussairaalassa hoidettujen aikuispotilaiden keuhkokuumeen etiologiaa sekä selvittää uusien mikrobiologisten pikamenetelmi¬en hyödyllisyyttä taudinaiheuttajan toteamisessa. Aineisto. Osatöiden I ja III aineisto koostui 384 Turun yliopistollisen keskussairaalaan infektio-osastolla hoidetusta keuhkokuumepotilaasta. Osatyössä I tutkittiin keuhkokuumeen aiheuttaja¬mikrobeja käyttämällä perinteisten menetelmien lisäksi antigeeniosoitukseen ja PCR-tekniikkaan perustuvia pikamenetelmiä. Osatyö II käsitti 231 potilaasta koostuvan alaryhmän, jossa tutkittiin potilaiden nielun limanäytteestä rinovirusten ja enterovirusten esiintyvyyttä. Osatyössä III potilailta tutkittiin plasman C-reaktiivisen proteiinin (CRP) pitoisuus ensimmäisten viiden sairaalahoitopäi¬vän aikana. Laajoja tilastotieteellisiä analyysejä käyttämällä selvitettiin CRP:n käyttökelpoisuutta sairauden vaikeusasteen arvioinnissa ja komplikaatioiden kehittymisen ennustamisessa. Osatyössä IV 68 keuhkokuumepotilaan sairaalaan tulovaiheessa otetuista näytteistä määritettiin neutrofiilien pintareseptorien ekspressio. Osatyössä V analysoitiin sisätautien vuodeosastoilla vuosina 1996-2000 keuhkokuumepotilaille tehtyjen keuhkohuuhtelunäytteiden laboratoriotutkimustulokset. Tulokset. Keuhkokuumeen aiheuttaja löytyi 209 potilaalta, aiheuttajamikrobeja löydettiin kaikkiaan 230. Näistä aiheuttajista 135 (58.7%) löydettiin antigeenin osoituksella tai PCR-menetelmillä. Suu¬rin osa, 95 (70.4%), todettiin pelkästään kyseisillä pikamenetelmillä. Respiratorinen virus todettiin antigeeniosoituksella 11.1% keuhkokuumepotilaalla. Eniten respiratorisia viruksia löytyi vakavaa keuhkokuumetta sairastavilta potilailta (20.3%). 231 keuhkokuumepotilaan alaryhmässä todettiin PCR-menetelmällä picornavirus 19 (8.2%) potilaalla. Respiratorinen virus löytyi tässä potilasryh¬mässä kaiken kaikkiaan 47 (20%) potilaalta. Näistä 17:llä (36%) löytyi samanaikaisesti bakteerin aiheuttama infektio. CRP-tasot olivat sairaalaan tulovaiheessa merkitsevästi korkeammat vakavaa keuhkokuumetta (PSI-luokat III-V) sairastavilla potilailla kuin lievää keuhkokuumetta (PSI-luokat I-II) sairastavilla potilailla (p <0.001). Yli 100 mg/l oleva CRP-taso neljän päivän kuluttua sairaa¬laan tulosta ennusti keuhkokuumeen komplikaatiota tai huonoa hoitovastetta. Neutrofiilien komple¬menttireseptorin ekspressio oli pneumokokin aiheuttamaa keuhkokuumetta sairastavilla merkitse¬västi korkeampi kuin influenssan aiheuttamaa keuhkokuumetta sairastavilla. BAL-näytteistä vain yhdessä 71:stä (1.3%) todettiin diagnostinen bakteerikasvu kvantitatiivisessa viljelyssä. Uusilla menetelmilläkin keuhkokuumeen aiheuttaja löytyi vain 9.8% BAL-näytteistä. Päätelmät. Uusilla antigeeniosoitus- ja PCR-menetelmillä keuhkokuumeen etiologia voidaan saada selvitettyä nopeasti. Lisäksi näitä menetelmiä käyttämällä taudin aiheuttajamikrobi löytyi huomattavasti suuremmalta osalta potilaista kuin pelkästään tavanomaisia menetelmiä käyttämällä. Pikamenetelmien hyödyllisyys vaihteli taudin vaikeusasteen mukaan. Respiratorinen virus löytyi huomattavan usein keuhkokuumetta sairastavilta potilailta, ja näiden potilaiden taudinkuva oli usein vaikea. Tulovaiheen korkeaa CRP-tasoa voidaan käyttää lisäkeinona arvioitaessa keuhkokuumeen vaikeutta. CRP on erityisen hyödyllinen arvioitaessa hoitovastetta ja riskiä komplikaatioiden ke¬hittymiseen. Neutrofiilien komplementtireseptorin ekspression tutkiminen näyttää lupaavalta pi¬kamenetelmältä erottamaan bakteerien ja virusten aiheuttamat taudit toisistaan. Antimikrobihoitoa saavilla potilailla BAL-tutkimuksen löydökset olivat vähäiset ja vaikuttivat hoitoon vain harvoin.

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    In the context of the evidence-based practices movement, the emphasis on computing effect sizes and combining them via meta-analysis does not preclude the demonstration of functional relations. For the latter aim, we propose to augment the visual analysis to add consistency to the decisions made on the existence of a functional relation without losing sight of the need for a methodological evaluation of what stimuli and reinforcement or punishment are used to control the behavior. Four options for quantification are reviewed, illustrated, and tested with simulated data. These quantifications include comparing the projected baseline with the actual treatment measurements, on the basis of either parametric or nonparametric statistics. The simulated data used to test the quantifications include nine data patterns in terms of the presence and type of effect and comprising ABAB and multiple baseline designs. Although none of the techniques is completely flawless in terms of detecting a functional relation only when it is present but not when it is absent, an option based on projecting split-middle trend and considering data variability as in exploratory data analysis proves to be the best performer for most data patterns. We suggest that the information on whether a functional relation has been demonstrated should be included in meta-analyses. It is also possible to use as a weight the inverse of the data variability measure used in the quantification for assessing the functional relation. We offer an easy to use code for open-source software for implementing some of the quantifications.