Pulmonar recruitment in acute respiratory distress syndrome. What is the best strategy?

Supporting patients with acute respiratory distress syndrome (ARDS), using a protective mechanical ventilation strategy characterized by low tidal volume and limitation of positive end-expiratory pressure (PEEP) is a standard practice in the intensive care unit. However, these strategies can promote lung de-recruitment, leading to the cyclic closing and reopening of collapsed alveoli and small airways. Recruitment maneuvers (RM) can be used to augment other methods, like positive end-expiratory pressure and positioning, to improve aerated lung volume. Clinical practice varies widely, and the optimal method and patient selection for recruitment maneuvers have not been determined, considerable uncertainty remaining regarding the appropriateness of RM. This review aims to discuss recent findings about the available types of RM, and compare the effectiveness, indications and adverse effects among them, as well as their impact on morbidity and mortality in ARDS patients. Recent developments include experimental and clinical evidence that a stepwise extended recruitment maneuver may cause an improvement in aerated lung volume and decrease the biological impact seen with the traditionally used sustained inflation, with less adverse effects. Prone positioning can reduce mortality in severe ARDS patients and may be an useful adjunct to recruitment maneuvers and advanced ventilatory strategies, such noisy ventilation and BIVENT, which have been useful in providing lung recruitment.

An Hp-Adaptive Hierarchical Formulation for the Boundary Element Method Applied to Elasticity in Two Dimensions

This paper presents an HP-Adaptive Procedure with Hierarchical formulation for the Boundary Element Method in 2-D Elasticity problems. Firstly, H, P and HP formulations are defined. Then, the hierarchical concept, which allows a substantial reduction in the dimension of equation system, is introduced. The error estimator used is based on the residual computation over each node inside an element. Finally, the HP strategy is defined and applied to two examples.

Collaborative Customer Relationship Management in Business-to-Business Firm's Strategy

The objective of this thesis is to study the presence of collaborative customer relationship management in a firm’s strategy. In addition the thesis explains specific implementations of collaborative CRM, and CRM in general, by each case company. The sample consists of five Finnish business-to-business companies through applying multiple-case study method. The data is collected through face-to-face interviews with employees knowledgeable of the case company’s CRM processes. The qualitative data is analyzed through coding and shows that two out of five case companies have adopted and are using collaborative CRM in their strategy and operations. These case companies see collaborative CRM as an important driver for the company, through customer focus and market orientation. The rest of the case companies are either in the process of moving towards collaborative CRM or have given little consideration to it. The results show that collaborative CRM is in use, and that each company modifies it to meet their exact aspirations. The major challenge in the process is to fully grasp the importance of a shared vision that can translate into collaborative efforts in CRM and business strategy.

A simple RT-PCR-based strategy for screening connexin identity

Vertebrate gap junctions are aggregates of transmembrane channels which are composed of connexin (Cx) proteins encoded by at least fourteen distinct genes in mammals. Since the same Cx type can be expressed in different tissues and more than one Cx type can be expressed by the same cell, the thorough identification of which connexin is in which cell type and how connexin expression changes after experimental manipulation has become quite laborious. Here we describe an efficient, rapid and simple method by which connexin type(s) can be identified in mammalian tissue and cultured cells using endonuclease cleavage of RT-PCR products generated from "multi primers" (sense primer, degenerate oligonucleotide corresponding to a region of the first extracellular domain; antisense primer, degenerate oligonucleotide complementary to the second extracellular domain) that amplify the cytoplasmic loop regions of all known connexins except Cx36. In addition, we provide sequence information on RT-PCR primers used in our laboratory to screen individual connexins and predictions of extension of the "multi primer" method to several human connexins.

Competence foresight: linking the identification of HR competences and competence management alignment with business strategy

The objective of this study was to increase understanding of the link between the identification of required HR competences and competence management alignment with business strategy in a Finnish, global company employing over 8,000 people and about 100 HR professionals. This aim was approached by analyzing the data collected in focus group interviews using a grounded theory method and in parallel reviewing the literature of strategic human resource management, competence-based strategic management, strategy and foresight. The literature on competence management in different contexts dismisses in-depth discussions on the foresight process and individuals are often forgotten in strategic frameworks. However, corporate foresight helps in the detection of emerging opportunities for innovations and in the implementation of strategy. The empirical findings indicate a lack of strategic leadership and an alignment with HR and business. Accordingly, the most important HR competence areas identified were the need for increasing business understanding and enabling change. As a result, the study provided a holistic model for competence foresight, which introduces HR professionals as strategic change agents in the role of organizational futurists at the heart of the company: facilitating competence foresight and competence development on individual as well as organizational levels, resulting in an agile organization with increased business understanding, sensitive sensors and adaptive actions to enable change.

Capillary electrophoresis: Applicability and method validation for biorefinery analytics

Wood-based bioprocesses present one of the fields of interest with the most potential in the circular economy. Expanding the use of wood raw material in sustainable industrial processes is acknowledged on both a global and a regional scale. This thesis concerns the application of a capillary zone electrophoresis (CZE) method with the aim of monitoring wood-based bioprocesses. The range of detectable carbohydrate compounds is expanded to furfural and polydatin in aquatic matrices. The experimental portion has been conducted on a laboratory scale with samples imitating process samples. This thesis presents a novel strategy for the uncertainty evaluation via in-house validation. The focus of the work is on the uncertainty factors of the CZE method. The CZE equipment is sensitive to ambient conditions. Therefore, a proper validation is essential for robust application. This thesis introduces a tool for process monitoring of modern bioprocesses. As a result, it is concluded that the applied CZE method provides additional results to the analysed samples and that the profiling approach is suitable for detecting changes in process samples. The CZE method shows significant potential in process monitoring because of the capability of simultaneously detecting carbohydrate-related compound clusters. The clusters can be used as summary terms, indicating process variation and drift.

Review of investment strategy, portfolio management, and scorecard based portfolio selection tool for direct property investments in Finland

The lack of research of private real estate is a well-known problem. Earlier studies have mostly concentrated on the USA or the UK. Therefore, this master thesis offers more information about the performance and risk associated with private real estate investments in Nordic countries, but especially in Finland. The structure of this master thesis is divided into two independent sections based on the research questions. In first section, database analysis is performed to assess risk-return ratio of direct real estate investment for Nordic countries. Risk-return ratios are also assessed for different property sectors and economic regions. Finally, review of diversification strategies based on property sectors and economic regions is performed. However, standard deviation itself is not usually sufficient method to evaluate riskiness of private real estate. There is demand for more explicit assessment of property risk. One solution is property risk scoring. In second section risk scorecard based tool is built to make different real estate comparable in terms of risk. In order to do this, nine real estate professionals were interviewed to enhance the structure of theory-based risk scorecard and to assess weights for different risk factors.

The Formation Of Internationalization Strategies Within The Construction Industry:Vision and Strategy

Internationalization represents a complex topic that has been researched for quite some time. However, since it continues to be extremely current a topic, its significance has not diminished, but maybe even increased in importance. Companies today face extreme pressure to enter new markets in the hope of growing, becoming more profitable, increasing market share, attracting new customers and meeting the requirements of its share- and stakeholders. In the increasingly global business environment of today, companies are facing both challenges and possible advantages of internationalization. Few companies are not operating internationally and it is becoming the question of ‘Why not?’ rather than ‘Why?’ to internationalize business operations. Internationalization and the importance of strategy are discussed in this research from the viewpoint of three case companies that were interviewed about internationalization strategies. This research project is a qualitative study that answers the research question of How is a business strategy constructed for entering a new market? The sub-questions are • How are goals set and what indicators are used to monitor the achievement of these goals? • What are the key characteristics of a strategy implementation process? The research method chosen for this study is a multiple-case study. Three case companies were chosen for the interviews in order to gain in-depth data of internationalization strategies within the construction industry.

A method of evaluating psychomotor tooth preparation skills in preclinical dental programs

Preclinical and clinical tooth important and significant aspect of preparation is an a dental student's education. The associated procedures rely heavily on the development of particular psychomotor skills. The most common format of instruction and evaluation in tooth preparation at many Dental Faculties, emphasizes the product (tooth preparation) and associates performance with characteristics of this product. This integrated study examines which skills should be developed and how a course of instruction can best be structured to develop the necessary skills. The skills which are identified are those necessary for tooth preparation are selected from a psychomotor taxonomy. The purpose of evaluating these skills is identified. Behavioral objectives are set for student performance and the advisability of establishing standards of performance is examined. After reviewing studies related to learning strategy for dental psychomotor the most suitable tasks as well as articles on instructor effectiveness a model is proposed. A pilot project at the University of Toronto, based on this proposed model is described. The paper concludes wi th a discussion of the implications of this proposed model.

Improving grade eight students' spelling performance with a triad strategy approach

Thesis (M.Ed.)-- Brock University, 1996.

The effectiveness of explicit strategy instruction on the top level structure of a text

Thesis (M.Ed.)-- Brock University, 1995.

Reflection Reframed: The Process of Photography as Strategy for Teachers' Reflective Practice

Teacher reflective practice is described as an effective method for engaging teachers in improving their own professional learning. Yet, some teachers do not understand how to effectively engage in the reflective processes, or prefer not to formalize the process through writing a reflective journal as taught in most teacher education programs. Developing reflective skills through the process of photography was investigated in this study as a strategy to allow enhanced teacher reflection for professional and personal growth. The process of photography is understood as the mindful act of photographing rather than focusing on the final product-the image. For this study, 3 practicing educators engaged in photographic exercises as a reflective process. Data sources included transcribed interviews, participant journal reflections, and sketchbook artifacts, as well as the researcher's personal journal notes. Findings indicated that, through the photographic process, (a) teacher participants developed new and individual strategies for professional leaming; and (b) teacher participants experienced shifts in the way they conceptualized their personal worldviews.

The perceptions of commune health workers about an education strategy received for counselling fathers about infant and breastfeeding involvement

Objective To evaluate the perceptions of healthcare workers in Vietnam about the efficacy of a continuing education strategy about father involvement and breastfeeding counselling. Design One group, post-test only, quasi-experimental design Method A questionnaire based on Social Cognitive Theory (SCT; Bandura, 2004) was disseminated to participants (N=28). This questionnaire measured self-efficacy, outcome expectations, socio-structural factors, goal setting and behaviour. Multiple regressions were analyzed predicting participants’ practice of client focused father involvement consulting. Results Bivariate correlations demonstrated the anticipated patterns of association between SCT-based constructs. Multiple regression analysis indicated that outcome expectations and barriers were significant predictors of client focused father involvement consulting. Conclusions Participants reported that the education increased their self-efficacy, outcome expectations and client focused father involvement consulting behaviour. Future education should be accessible, increase counselling confidence and address beliefs about the outcomes and challenges of father involvement consulting.

Estimating Nonlinear DSGE Models by the Simulated Method of Moments

This paper studies the application of the simulated method of moments (SMM) for the estimation of nonlinear dynamic stochastic general equilibrium (DSGE) models. Monte Carlo analysis is employed to examine the small-sample properties of SMM in specifications with different curvature. Results show that SMM is computationally efficient and delivers accurate estimates, even when the simulated series are relatively short. However, asymptotic standard errors tend to overstate the actual variability of the estimates and, consequently, statistical inference is conservative. A simple strategy to incorporate priors in a method of moments context is proposed. An empirical application to the macroeconomic effects of rare events indicates that negatively skewed productivity shocks induce agents to accumulate additional capital and can endogenously generate asymmetric business cycles.

Strategy-proof preference aggregation

An aggregation rule maps each profile of individual strict preference orderings over a set of alternatives into a social ordering over that set. We call such a rule strategyproof if misreporting one’s preference never produces a social ordering that is strictly between the original ordering and one’s own preference. After describing a few examples of manipulable rules, we study in some detail three classes of strategy-proof rules: (i)rules based on a monotonic alteration of the majority relation generated by the preference profile; (ii)rules improving upon a fixed status-quo; and (iii) rules generalizing the Condorcet-Kemeny aggregation method.