Knowledge hierarchy and professional knowledge

The aim of this article is to substantiate, in the sociological point of view, the distinction between the social and cognitive processes that produce knowledge in knowledge abstract systems - KAS - to generate cultural inequality and the micro processes of knowledge usage, which build local and cultural knowledge from common sense. It is circumscribed to this aim a problematization of knowledge usage developed by middle class salaried professional groups, rich in cultural capital but without equivalent symbolical capital, in a capitalist society at risk. In order to achieve this goal, the classical contributions of Pierre Bourdieu, Boaventura Sousa Santos, Donald Schön and Basil Bernstein (among others) are taken as a basis regarding the limitation of critical and reflexive thinking and the virtues of professional knowledge to support an epistemology of professional practice.

Laparoscopic surgery for coeliac artery compression syndrome: current management and technical aspects.

Objectives: The study aims to assess the feasibility and midterm outcome of trans-peritoneal laparoscopy for coeliac artery compression syndrome (CACS).Design: Retrospective chart review involving four European vascular surgery departments and two surgical teams.Materials and methods: charts for patients who underwent laparoscopy for symptomatic CACS between December 2003 and November 2009 were reviewed. Preoperative computed tomography (CT) angiography and postoperative duplex scan and/or CT angiography were performed.Results: Eleven consecutive patients (nine women) with a median age of 52 years (interquartile range: 42.5-59 years) underwent trans-peritoneal laparoscopy for CACS. All patients had a history of postprandial abdominal pain; weight loss exceeded 10% of the body mass in eight cases. Preoperative CT angiography revealed coeliac trunk stenosis >70% in all cases. One patient had additional aortitis and inferior mesenteric artery occlusion, while another patient presented with an occluded superior mesenteric artery. Two conversions occurred (one difficult dissection and one aorto-hepatic bypass needed for incomplete release of CACS). The median blood loss was 195 ml (range: 50-900 ml) and median operative time was 80 min (interquartile range: 65-162.5 years). Symptoms improved immediately in 10/11 patients (no residual stenosis) while one remained unchanged despite a residual stenosis treated by a percutaneous angioplasty. Symptoms reappeared in one patient due to coeliac axis occlusion. The mean follow-up period was 35 +/- 23 months (range: 12-78 months).Conclusion: Our study demonstrates that trans-peritoneal laparoscopy for treating median arcuate ligament syndrome is safe and feasible. Additional patients and a longer follow-up are needed for long-term assessment of this laparoscopic technique. (C) 2011 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

Improvement of cardiovascular risk prediction: time to review current knowledge, debates, and fundamentals on how to assess test characteristics.

Cardiovascular risk assessment might be improved with the addition of emerging, new tests derived from atherosclerosis imaging, laboratory tests or functional tests. This article reviews relative risk, odds ratios, receiver-operating curves, posttest risk calculations based on likelihood ratios, the net reclassification improvement and integrated discrimination. This serves to determine whether a new test has an added clinical value on top of conventional risk testing and how this can be verified statistically. Two clinically meaningful examples serve to illustrate novel approaches. This work serves as a review and basic work for the development of new guidelines on cardiovascular risk prediction, taking into account emerging tests, to be proposed by members of the 'Taskforce on Vascular Risk Prediction' under the auspices of the Working Group 'Swiss Atherosclerosis' of the Swiss Society of Cardiology in the future.

Water scarcity management and agricultural production (What we can do to produce more with less water)

Crop seasonal sensitivity to water stress is concerned with how to control water stress levels to optimise yield or profitability. It deals with when we can reduce irrigation and impose moderate water deficits without affecting our target, and when we can apply water to avoid too much stress.

Pavement Management and Rehabilitation of Portland Cement Concrete Pavements, MLR-80-01, 1981

None provided.

Clinical management and burden of bipolar disorder: a multinational longitudinal study (WAVE-bd Study)

BACKGROUND: Studies in bipolar disorder (BD) to date are limited in their ability to provide a whole-disease perspective--their scope has generally been confined to a single disease phase and/or a specific treatment. Moreover, most clinical trials have focused on the manic phase of disease, and not on depression, which is associated with the greatest disease burden. There are few longitudinal studies covering both types of patients with BD (I and II) and the whole course of the disease, regardless of patients' symptomatology. Therefore, the Wide AmbispectiVE study of the clinical management and burden of Bipolar Disorder (WAVE-bd) (NCT01062607) aims to provide reliable information on the management of patients with BD in daily clinical practice. It also seeks to determine factors influencing clinical outcomes and resource use in relation to the management of BD. METHODS: WAVE-bd is a multinational, multicentre, non-interventional, longitudinal study. Approximately 3000 patients diagnosed with BD type I or II with at least one mood event in the preceding 12 months were recruited at centres in Austria, Belgium, Brazil, France, Germany, Portugal, Romania, Turkey, Ukraine and Venezuela. Site selection methodology aimed to provide a balanced cross-section of patients cared for by different types of providers of medical aid (e.g. academic hospitals, private practices) in each country. Target recruitment percentages were derived either from scientific publications or from expert panels in each participating country. The minimum follow-up period will be 12 months, with a maximum of 27 months, taking into account the retrospective and the prospective parts of the study. Data on demographics, diagnosis, medical history, clinical management, clinical and functional outcomes (CGI-BP and FAST scales), adherence to treatment (DAI-10 scale and Medication Possession Ratio), quality of life (EQ-5D scale), healthcare resources, and caregiver burden (BAS scale) will be collected. Descriptive analysis with common statistics will be performed. DISCUSSION: This study will provide detailed descriptions of the management of BD in different countries, particularly in terms of clinical outcomes and resources used. Thus, it should provide psychiatrists with reliable and up-to-date information about those factors associated with different management patterns of BD. TRIAL REGISTRATION NO: ClinicalTrials.gov: NCT01062607.

High-growth firms and innovation: an empirical analysis for Spanish firms

This paper analyses the effect of R&D investment on firm growth. We use an extensive sample of Spanish manufacturing and service firms. The database comprises diverse waves of Spanish Community Innovation Survey and covers the period 2004–2008. First, a probit model corrected for sample selection analyses the role of innovation on the probability of being a high-growth firm (HGF). Second, a quantile regression technique is applied to explore the determinants of firm growth. Our database shows that a small number of firms experience fast growth rates in terms of sales or employees. Our results reveal that R&D investments positively affect the probability of becoming a HGF. However, differences appear between manufacturing and service firms. Finally, when we study the impact of R&D investment on firm growth, quantile estimations show that internal R&D presents a significant positive impact for the upper quantiles, while external R&D shows a significant positive impact up to the median. Keywords : High-growth firms, Firm growth, Innovation activity. JEL Classifications : L11, L25, L26, O30

Measuring discrepancies between knowledge, preoccupation and fear of aids in populations.

A simple tool to quantify discrepancies between knowledge, preoccupation and fear regarding hiv and aids is presented. This tool is based on standard questions available in health surveys. Some results using recent Swiss data are presented, and the method is discussed.

Organisaation uudistumiskyvyn kehittäminen, Case: Stora Enso

Tutkielman tavoitteena oli selvittää case-organisaatio Stora Enson Anjalan paperitehtaan uudistumiskyky, toiminnan strategianmukaisuus sekä vahvuudet ja kehitettävät osa-alueetuudistumiskyvyssä. Tutkielmassa käytettiin kvantitatiivista tutkimusotetta. Aineisto kerättiin kahdella eri mittarilla: KM-Factor¿ ¿ uudistumiskyvyn mittarilla ja organisaation muutoskyvyn mittarilla. KM-Factor¿ ¿mittarin avulla kerättiin tietoa organisaation suhteiden, tiedonkulun, osaamisen ja johtamisen nyky- ja tavoitetilasta erilaisissa tietoympäristöissä. Muutoskyvyn mittarin avulla kerättiin tietoa organisaation uudistumiskyvystä kuuden sitä kuvaavan ominaisuuden, strategisen kyvykkyyden, johtajuuden, ajan hyödyntämisen, verkostoituneisuuden, tiedon johtamisen ja oppimissuuntautuneisuuden perusteella. Mittaukset suoritettiin helmikuussa 2006 ja niiden kohteena oli Stora Enson Anjalan paperitehtaan koko henkilöstö. Kahden uudistumiskyvyn mittarin tulokset analysoitiin ja niitä vertailtiin keskenään. Tällä tavalla pyrittiinmyös lisäämään tutkimuksen validiteettia. Mittaustulokset purettiin sanalliseenmuotoon ja niistä raportoitiin case-organisaatiolle. Mittausten mukaan case-organisaation uudistumiskyky oli hieman keskitasoa heikompi. Toiminnan vahvuuksia olivat yksimielisyys muutostarpeista ja tilanneherkkyys. Merkittävimmät toiminnan heikkoudet löytyivät nykyisestä toimintatavasta, joka ei ollut strategian mukainen, ja innovaatiopotentiaalista, joka oli hyvin alhainen. Kehittämisen tarpeita löytyi sekä johdon että henkilöstön suhteiden ja yhteistyön osalta. Koko organisaation tulisi lisätä yhteistyötä ulkopuolisten tahojen ja sidosryhmien kanssa. Organisaatiossa tulisi miettiä, miten strategia saataisiin selkeästi viestittyä myös johtoa alemmille tasoille. Johto painotti liikaa autoritääristä johtamista, kun taas henkilöstöltä odotettaisiin enemmän vastuunottoa toiminnastaan. Organisaatiossa tulisi saada nykyistä avoimemmin ja itsenäisemmin ilmaista omia näkemyksiään, toimia aloitteellisesti ja luoda uusia ideoita toiminnan kehittämiseksi. Innovatiivisuudesta ja parannusehdotuksista tulisi myös palkita paremmin.