Effects of different levels of positive airway pressure on breathing pattern and heart rate variability after coronary artery bypass grafting surgery

The application of continuous positive airway pressure (CPAP) produces important hemodynamic alterations, which can influence breathing pattern (BP) and heart rate variability (HRV). The aim of this study was to evaluate the effects of different levels of CPAP on postoperative BP and HRV after coronary artery bypass grafting (CABG) surgery and the impact of CABG surgery on these variables. Eighteen patients undergoing CABG were evaluated postoperatively during spontaneous breathing (SB) and application of four levels of CPAP applied in random order: sham (3 cmH2O), 5 cmH2O, 8 cmH2O, and 12 cmH2O. HRV was analyzed in time and frequency domains and by nonlinear methods and BP was analyzed in different variables (breathing frequency, inspiratory tidal volume, inspiratory and expiratory time, total breath time, fractional inspiratory time, percent rib cage inspiratory contribution to tidal volume, phase relation during inspiration, phase relation during expiration). There was significant postoperative impairment in HRV and BP after CABG surgery compared to the preoperative period and improvement of DFAα1, DFAα2 and SD2 indexes, and ventilatory variables during postoperative CPAP application, with a greater effect when 8 and 12 cmH2O were applied. A positive correlation (P < 0.05 and r = 0.64; Spearman) was found between DFAα1 and inspiratory time to the delta of 12 cmH2O and SB of HRV and respiratory values. Acute application of CPAP was able to alter cardiac autonomic nervous system control and BP of patients undergoing CABG surgery and 8 and 12 cmH2O of CPAP provided the best performance of pulmonary and cardiac autonomic functions.

Anti-Leishmania titers and positive skin tests in patients cured of kala-azar

Visceral leishmaniasis (VL), also known as kala-azar, is an important public health problem. If not treated, virtually all clinically symptomatic patients die within months. The diagnosis is based on the Montenegro skin test (MST) and anti-Leishmania titers. Nevertheless, the time required for cured individuals living in a leishmaniasis-endemic area to present a positive skin test and negative anti-Leishmania serology is known. To determine the cellular and humoral immune response profile in relation to different times post-VL cure, a cross-sectional study was conducted on subjects from a kala-azar endemic area in Paço do Lumiar, MA, Brazil, on the basis of 1995-2005 notifications reported by the National Health Foundation/Regional Coordination of Maranhão. We visited cured individuals with a history of VL within the last 10 years. Seventy-four subjects (30 females) ranging in age from 1 to 44 years were included, all of them symptom free at the time of the study. A cellular immune response was observed in 73 (98.6%) subjects, whereas no significant antibody titers were detected by indirect immunofluorescence (IIF) in the sera of 69 (93.2%) cases. Ten years post-cure, 39 (52%) subjects had a positive MST and negative IIF reaction, while in one subject the skin and anti-Leishmania serology tests were negative. Two other subjects were positive in both tests 1 year after cure. These data suggest that a cellular immune response may still be present in subjects cured of VL regardless of post-cure time, and that the parasite persists in the host after clinical cure of the disease. This would explain the persistence of significant Leishmania sp antibody titers in some subjects after treatment.

Application of continuous positive airway pressure in the delivery room: a multicenter randomized clinical trial

This study evaluated whether the use of continuous positive airway pressure (CPAP) in the delivery room alters the need for mechanical ventilation and surfactant during the first 5 days of life and modifies the incidence of respiratory morbidity and mortality during the hospital stay. The study was a multicenter randomized clinical trial conducted in five public university hospitals in Brazil, from June 2008 to December 2009. Participants were 197 infants with birth weight of 1000-1500 g and without major birth defects. They were treated according to the guidelines of the American Academy of Pediatrics (APP). Infants not intubated or extubated less than 15 min after birth were randomized for two treatments, routine or CPAP, and were followed until hospital discharge. The routine (n=99) and CPAP (n=98) infants studied presented no statistically significant differences regarding birth characteristics, complications during the prenatal period, the need for mechanical ventilation during the first 5 days of life (19.2 vs 23.4%, P=0.50), use of surfactant (18.2 vs 17.3% P=0.92), or respiratory morbidity and mortality until discharge. The CPAP group required a greater number of doses of surfactant (1.5 vs 1.0, P=0.02). When CPAP was applied to the routine group, it was installed within a median time of 30 min. We found that CPAP applied less than 15 min after birth was not able to reduce the need for ventilator support and was associated with a higher number of doses of surfactant when compared to CPAP applied as clinically indicated within a median time of 30 min.

Standardization of a multiplex PCR for the identification of coagulase-positive Staphylococcus

The enterotoxigenic species Staphylococcus aureus, S. hyicus and S. intermedius show very similar characteristics, making their identification through conventional microbiological methods difficult. This study aimed at the development of a Multiplex PCR (mPCR) for the identification of S. aureus, S. intermedius and S. hyicus using the nuc gene as the target sequence. The results obtained suggest that the set of primers used was specific for the three species of Staphylococcus evaluate with a detection limit of 10² CFU.mL-1.

Ocurrence of Vibrio spp., positive coagulase staphylococci and enteric bacteria in oysters (Crassostrea gigas) harvested in the south bay of Santa Catarina island, Brazil

The aim of this study was to assess the contamination of oysters (Crassostrea gigas), harvested in six different regions of the South Bay of Santa Catarina Island, with Coliforms at 45 ºC, Escherichia coli, Vibrio spp., positive coagulase staphylococci, and Salmonella sp. over a period of one year. One hundred eighty oyster samples were collected directly from their culture sites and analyzed. Each sample consisted of a pool of 12 oysters. All of the samples analyzed showed absence of Salmonella, 18 (10%) samples showed presence of Escherichia coli, 15 (8.3%) samples were positive for V. alginolyticus, and Vibriocholerae was detected in 4 samples (2.2%). The counts of positive-coagulase staphylococci varied from <10 to 1.9 x 102 CFU.g-1, whereas the counts of Coliforms at 45 ºC and E. coli ranged from <3 to 1.5 x 102 MPN.g-1 and <3 and 4.3 x 10 MPN.g-1, respectively. Counts of V. parahaemolyticus and V. vulnificus ranged between <3 and 7 MPN.g-1, for both microorganisms. This suggests the need for monitoring these Vibrios contamination in oysters. Based on the results of the microbiological assays, the samples analyzed showed acceptable bacteriological quality, i.e., they were within the parameters established by Brazilian Legislation.

New ways to do business plans in multicultural organizations

Business plans are made when establishing new company or when organizations launch new product or services. In this Master Thesis was examined the elements are included in the business plan and emphasized. Business plan is a wide document and can also contain company specific information, the literature review was restricted into three areas which were investigated from the relating literature and articles. The selected areas were Market Segmentation and Targeting, Competitive Environment, and Market Positioning and Strategy. The different business plan models were investigated by interviewing companies who operates in a different industry sectors from each other’s. The models were compared to each other and to the findings from literature. Based on interview results and literature findings, the business plan for fibre based packaging. The created business plan contains three selected areas. It was found that the selected business plan elements can be found from the interviewed companies’ business plans. The market segmentation was done by comparing the market share to known total market size. When analyzing the competitive environment, there was no one selected model in use. The tools to evaluate competitive environment was selected parts from both SWOT analysis and Porter’s five forces model in applicable part. Based on interview results, it can be state that the company or organization should find and built its own model for business plans. In order to receive the benefits for future planning, the company should use the same model for long time.

The role of business model in computer game development organizations

The computer game industry has grown steadily for years, and in revenues it can be compared to the music and film industries. The game industry has been moving to digital distribution. Computer gaming and the concept of business model are discussed among industrial practitioners and the scientific community. The significance of the business model concept has increased in the scientific literature recently, although there is still a lot of discussion going on on the concept. In the thesis, the role of the business model in the computer game industry is studied. Computer game developers, designers, project managers and organization leaders in 11 computer game companies were interviewed. The data was analyzed to identify the important elements of computer game business model, how the business model concept is perceived and how the growth of the organization affects the business model. It was identified that the importance of human capital is crucial to the business. As games are partly a product of creative thinking also innovation and the creative process are highly valued. The same applies to technical skills when performing various activities. Marketing and customer relationships are also considered as key elements in the computer game business model. Financing and partners are important especially for startups, when the organization is dependent on external funding and third party assets. The results of this study provide organizations with improved understanding on how the organization is built and what business model elements are weighted.

Challenges for virtual teams in voluntary organizations

This research concerns virtual teams in the field of volunteer work. The developments in the area of information and communication technology have decreased their costs and made them easily accessible. As a result, it seems natural that also the voluntary organizations have adopted online tools and virtual teams as a part of their work modes. However, virtual teams have not received much research in this context, and one of the goals of this study was to begin closing that gap. The research had two main focus areas: the challenges that the volunteers face in the teams, and the leadership that the teams have. The study used a qualitative approach and semi-structured interviews. The interviews were conducted over Skype and email and included members from six different teams. The case organization was a European-wide student organization that widely utilized virtual teams in its work. The study identified three critical issues for managing the virtual teams. The first challenge was creating common ground for teamwork through electronic communication. Secondly, volunteering created challenges for the teams through variations in the level of commitment of the members, as some left the organization during the term of the team. Lastly, knowledge transfer was a challenge that came from changing the team members regularly each year. As for the second key topic, leadership in the teams was spread among the team members unevenly. The teams had a formal leader, but they exhibited signs of shared leadership, and the team members were able to influence the team through their own level of involvement. Especially the experience that a member had contributed the amount of influence she held. All in all, the challenges that the volunteers faced were similar to those of normal virtual teams. Volunteering brought additional challenges through the varying levels of commitment and the changing of the team members. Additionally, the role of the team leader was not as firm. The results of the study can be applied to other volunteer organizations that utilize virtual teams.

Challenges for virtual teams in voluntary organizations

This research concerns virtual teams in the field of volunteer work. The developments in the area of information and communication technology have decreased their costs and made them easily accessible. As a result, it seems natural that also the voluntary organizations have adopted online tools and virtual teams as a part of their work modes. However, virtual teams have not received much research in this context, and one of the goals of this study was to begin closing that gap. The research had two main focus areas: the challenges that the volunteers face in the teams, and the leadership that the teams have. The study used a qualitative approach and semi-structured interviews. The interviews were conducted over Skype and email and included members from six different teams. The case organization was a European-wide student organization that widely utilized virtual teams in its work. The study identified three critical issues for managing the virtual teams. The first challenge was creating common ground for teamwork through electronic communication. Secondly, volunteering created challenges for the teams through variations in the level of commitment of the members, as some left the organization during the term of the team. Lastly, knowledge transfer was a challenge that came from changing the team members regularly each year. As for the second key topic, leadership in the teams was spread among the team members unevenly. The teams had a formal leader, but they exhibited signs of shared leadership, and the team members were able to influence the team through their own level of involvement. Especially the experience that a member had contributed the amount of influence she held. All in all, the challenges that the volunteers faced were similar to those of normal virtual teams. Volunteering brought additional challenges through the varying levels of commitment and the changing of the team members. Additionally, the role of the team leader was not as firm. The results of the study can be applied to other volunteer organizations that utilize virtual teams.

Organizational creativity – Hegemonic and alternative discourses

SUMMARY Organizational creativity – hegemonic and alternative discourses Over the course of recent developments in the societal and business environment, the concept of creativity has been brought into new arenas. The rise of ‘creative industries’ and the idea of creativity as a form of capital have attracted the interests of business and management professionals – as well as academics. As the notion of creativity has been adopted in the organization studies literature, the concept of organizational creativity has been introduced to refer to creativity that takes place in an organizational context. This doctoral thesis focuses on organizational creativity, and its purpose is to explore and problematize the hegemonic organizational creativity discourse and to provide alternative viewpoints for theorizing about creativity in organizations. Taking a discourse theory approach, this thesis, first, provides an outline of the currently predominant, i.e. hegemonic, discourse on organizational creativity, which is explored regarding themes, perspectives, methods and paradigms. Second, this thesis consists of five studies that act as illustrations of certain alternative viewpoints. Through these exemplary studies, this thesis sheds light on the limitations and taken-for-granted aspects of the hegemonic discourse and discusses what these alternative viewpoints could offer for the understanding of and theorizing for organizational creativity. This study leans on an assumption that the development of organizational creativity knowledge and the related discourse is not inevitable or progressive but rather contingent. The organizational creativity discourse has developed in a certain direction, meaning that some themes, perspectives, and methods, as well as assumptions, values, and objectives, have gained a hegemonic position over others, and are therefore often taken for granted and considered valid and relevant. The hegemonization of certain aspects, however, contributes to the marginalization of others. The thesis concludes that the hegemonic discourse on organizational creativity is based on an extensive coverage of certain themes and perspectives, such as those focusing on individual cognitive processes, motivation, or organizational climate and their relation to creativity, to name a few. The limited focus on some themes and the confinement to certain prevalent perspectives, however, results in the marginalization of other themes and perspectives. The negative, often unintended, consequences, implications, and side effects of creativity, the factors that might hinder or prevent creativity, and a deeper inquiry into the ontology and epistemology of creativity have attracted relatively marginal interest. The material embeddedness of organizational creativity, in other words, the physical organizational environment as well as the human body and its non-cognitive resources, has largely been overlooked in the hegemonic discourse, although thereare studies in this area that give reason to believe that they might prove relevant for the understanding of creativity. The hegemonic discourse is based on an individual-centered understanding of creativity which overattributes creativity to an individual and his/her cognitive capabilities, while simultaneously neglecting how, for instance, the physical environment, artifacts, social dynamics and interactions condition organizational creativity. Due to historical reasons, quantitative as well as qualitative yet functionally- oriented studies have predominated the organizational creativity discourse, although studies falling into the interpretationist paradigm have gradually become more popular. The two radical paradigms, as well as methodological and analytical approaches typical of radical research, can be considered to hold a marginal position in the field of organizational creativity. The hegemonic organizational creativity discourse has provided extensive findings related to many aspects of organizational creativity, although the con- ceptualizations and understandings of organizational creativity in the hegemonic discourse are also in many respects limited and one-sided. The hegemonic discourse is based on an assumption that creativity is desirable, good, necessary, or even obligatory, and should be encouraged and nourished. The conceptualiza- tions of creativity favor the kind of creativity which is useful, valuable and can be harnessed for productivity. The current conceptualization is limited to the type of creativity that is acceptable and fits the managerial ideology, and washes out any risky, seemingly useless, or negative aspects of creativity. It also limits the possible meanings and representations that ‘creativity’ has in the respective discourse, excluding many meanings of creativity encountered in other discourses. The excessive focus on creativity that is good, positive, productive and fits the managerial agenda while ignoring other forms and aspects of creativity, however, contributes to the dilution of the notion. Practices aimed at encouraging the kind of creativity may actually entail a risk of fostering moderate alterations rather than more radical novelty, as well as management and organizational practices which limit creative endeavors, rather than increase their likelihood. The thesis concludes that although not often given the space and attention they deserve, there are alternative conceptualizations and understandings of organizational creativity which embrace a broader notion of creativity. The inability to accommodate the ‘other’ understandings and viewpoints within the organizational creativity discourse runs a risk of misrepresenting the complex and many-sided phenomenon of creativity in organizational context. Keywords: Organizational creativity, creativity, organization studies, discourse theory, hegemony

Investigating the Existence of Business-IT Alignment Trap in Finnish IT Organizations

The overall purpose of this master's thesis is to investigate the existence of business-IT alignment trap in Finnish IT organizations. The alignment trap refers to the inability of IT investments to deliver the expected business benefits. The basis for this investigation is due to the previous knowledge that high level of IT alignment practice with very low efficacy in an organization can lead to alignment trap. The theory which was established on the dimensions of IT-alignment and efficacy of IT as a whole with considerations for cost reduction and revenue growth benefits. This study explored the same dimensions with the previous study but identified additional benefit (profitability). The study was conducted using the Finnish IT barometer data from different IT organizations. A quantitative research method was used in conducting this study which was built on positivist philosophical stance. The empirical data is based on survey data, an excerpt from the Finnish IT barometer data that captured the annual survey results of IT significance to Finnish organizations as evaluated by business and IT professionals. The survey data comprised of 249 respondents and their responses were categorized into high and low IT intensive which form the basis of the statistical analysis conducted. Overall, five analyses were conducted using the variables of cost reductions, revenue growth and profitability in the 2x2 matrix dimensions of IT alignment and efficacy of IT, grouped into alignment trap, maintenance zone, well-oiled IT and IT-enabled growth. The empirical results, revealed a partial existence of alignment trap in Finnish IT organizations. This is due to a very minute number of organizations that were ensnared in the alignment trap zone on the analyses conducted. Although they recorded considerable high performances in terms of revenue growth rate with IT spending below the average companies, their profitability was considered very low. Generally it was observed that Finnish IT organizations with high efficacy of IT practices had good performances, while those with low efficacy of IT experienced low performances, especially in the aspect of profitability, regardless of the degree of IT alignment. The study proposes that organizations should improve on practices that enhance effectiveness of IT more in order for them to realize the full benefits of IT and to avoid alignment trap.

Forecasting with social media – Using Facebook likes to predict the results of the 2015 Finnish Parliamentary elections

Already one-third of the human population uses social media on a daily basis. The biggest social networking site Facebook has over billion monthly users. As a result, social media services are now recording unprecedented amount of data on human behavior. The phenomenon has certainly caught the attention of scholars, businesses and governments alike. Organizations around the globe are trying to explore new ways to benefit from the massive databases. One emerging field of research is the use of social media in forecasting. The goal is to use data gathered from online services to predict offline phenomena. Predicting the results of elections is a prominent example of forecasting with social media, but regardless of the numerous attempts, no reliable technique has been established. The objective of the research is to analyze how accurately the results of parliament elections can be forecasted using social media. The research examines whether Facebook “likes” can be effectively used for predicting the outcome of the Finnish parliament elections that took place in April 2015. First a tool for gathering data from Facebook was created. Then the data was used to create an electoral forecast. Finally, the forecast was compared with the official results of the elections. The data used in the research was gathered from the Facebook walls of all the candidates that were running for the parliament elections and had a valid Facebook page. The final sample represents 1131 candidates and over 750000 Facebook “likes”. The results indicate that creating a forecast solely based on Facebook “likes” is not accurate. The forecast model predicted very dramatic changes to the Finnish political landscape while the official results of the elections were rather moderate. However, a clear statistical relationship between “likes” and votes was discovered. In conclusion, it is apparent that citizens and other key actors of the society are using social media in an increasing rate. However, the volume of the data does not directly increase the quality of the forecast. In addition, the study faced several other limitations that should be addressed in future research. Nonetheless, discovering the positive correlation between “likes” and votes is valuable information that can be used in future studies. Finally, it is evident that Facebook “likes” are not accurate enough and a meaningful forecast would require additional parameters.