Characterising the Quality Journey of Total Quality Management in Relation to the Financial Performance of SMEs Under Crisis Conditions: the Case for Greece

During the last few years Greece is coping with severe economic and financial crisis conditions. Since the Greek SME are the largest productive and economic sector in the Greek economy, they bear the brunt of consequences for these adverse conditions. This thesis investigates the role of the total quality elements in improving or otherwise the financial performance of those SME. Ratio analysis is used as a mean of measuring the SME financial performance and specifically the level of their liquidity, profitability, efficiency and solvency. Furthermore the thesis tries to identify the role that each quality element and quality as a whole, have on different size SME and their financial performance. A data-triangulation methodology was developed to examine the influence of the above factors (use of a questionnaire and a set of semi-structured interviews) and the results and the conclusions derived have shown that:- - All the Greek SME have the intention to continue their quality journey to TQM. - Small SME give more emphasis in implementing the TQM elements, followed by the micro and the medium size SME respectively. However each group of SME prioritises differently the various quality elements. - The ratio analysis revealed that the group with the mostly improved financial performance was the micro SME followed by the small and the medium SME. - The worst financial performance of all the SME occurred between 2008 and 2010. - Amongst the SME that have managed to continue to operate, the ones characterised as TQM SME have shown an improved financial performance. Measuring the SME financial performance, efficiency and solvency were revealed as the most significant variables. The smaller in size the SME were, they pay a greater attention to efficiency while the larger SME pay more attention to solvency. - Utilising the Z-score rate as a criterion, the largest number of transitions among different levels of financial sustainability was revealed from the micro SME. Lower variability was identified from the TQM SME group in comparison with the other two groups of SME (ISO+ and ISO) that have also shown a very similar behaviour. In conclusion SME’s that have followed the ISO to TQM journey during the harsh financial conditions they were facing, they have managed to harbour themselves better in conditions of financial crisis

Production and state-selective detection of ultracold, ground state RbCs molecules

Using resonance-enhanced two-photon ionization, we detect ultracold, ground-state RbCs molecules formed via photoassociation in a laser-cooled mixture of 85Rb and 133Cs atoms. We obtain extensive bound-bound excitation spectra of these molecules, which provide detailed information about their vibrational distribution, as well as spectroscopic data on the RbCs ground a^3\Sigma^+ and excited (2)^3\Sigma^+, (1)^1\Pi states. Analysis of this data allows us to predict strong transitions from observed excited levels to the absolute vibronic ground state of RbCs, potentially allowing the production of stable, ultracold polar molecules at rates as large as 10^7 s^{-1}

Many-Body Electrostatic Forces Between Colloidal Particles at Vanishing Ionic Strength

Electrostatic forces between small groups of colloidal particles are measured using blinking optical tweezers. When the electrostatic screening length is significantly larger than the particle radius, forces are found to be non-pairwise additive. Both pair and multi-particle forces are well described by the linearized Poisson-Boltzmann equation with constant potential boundary conditions. These findings may play an important role in understanding the structure and stability of a wide variety of systems, from micron-sized particles in oil to aqueous nanocolloids.Comment: 5 pages 2 figure

Anämie und Transfusion von Erythrozytenkonzentraten bei prolongiert mechanisch beatmeten, tracheotomierten Patienten - Korrelation mit Beatmungsdauer, nosokomialen Infektionen und nichtinfektiösen Komplikationen: eine retrospektive Studie

Die prolongierte Respiratorentwöhnung betrifft die invasiv beatmeten Patienten, die schon mindestens drei erfolglose Spontanatmungsversuche hatten oder länger als sieben Tage nach dem ersten erfolglosen Spontanatmungsversuch beatmet werden. Dieses Verfahren findet in spezialisierten Weaningzentren statt. Die Transfusion von Erythrozytenkonzentraten wird in der Beatmungsmedizin bei anämischen Patienten eingesetzt. Diese Arbeit beschäftigte sich mit den Auswirkungen der Transfusion und dem optimalen Transfusionstrigger. In dem Weaningzentrum der Klinik Schillerhöhe wurden die Daten von 378 Patienten zwischen Dezember 2011 und Dezember 2016 in unserer retrospektiven Observationsstudie erhoben. Die Patientencharakteristika, die Morbidität, die transfusionsrelevanten Daten und mehrere Endpunkte wurden erfasst. Die Korrelation zwischen Transfusion und Endpunkten wurde analysiert. Die klinische Stabilität bei der Aufnahme in unserem Weaningzentrum, die von Intensivstationen abweichenden Apache-II-Score und Aufnahmehämoglobin zeigen, dass die Patienten im prolongierten Weaning ein spezielles Kollektiv aufweisen und prinzipiell gesondert bezüglich des Transfusionstriggers analysiert werden sollen. Die häufigste Ursache der akuten respiratorischen Insuffizienz war die Pneumonie mit 31% und die häufigste Vorerkrankung war die kardiale Erkrankung mit 42,3%. Der Weaningerfolg, definiert als Weaningkategorie 3a und 3b, konnte in 69,8% der Fälle erzielt werden und 50,5% aller Patienten wurden vom Respirator vollständig entwöhnt. Das Weaningversagen errechnete sich bei 30,2%. Die Weaningdauer betrug 23,0 (± 16,2) Tage. 41,8% der Patienten erlitten eine infektiöse Komplikation. Die häufigsten Infektionen waren die Harnwegsinfektion mit 28,1% und die Ventilator-assoziierte Tracheobronchitis mit 22,4%. Die Transfusion ergab sich in der Cox-Regressionsanalyse als der einzige unabhängige Risikofaktor für die Zeit bis zur ersten Infektion mit einer Hazard Ratio von 0,965 (p-Wert =0,001). Im Weaning-Zeitraum wurde 44,4% der Patienten transfundiert. Es ergaben sich im Weaning-Zeitraum im Durchschnitt 1,5 (±2,9) Erythrozytenkonzentrate pro Patient. Der Mittelwert des Prätransfusionshämoglobins im Weaning-Zeitraum betrug in unserer Studie 75,2 g/l (±5,2). Das mediane Hämoglobin und die Transfusion zeigten keine statistisch signifikante Korrelation mit dem erfolglosen Weaning. Die Transfusion korrelierte unabhängig mit der Weaningdauer. Die Krankenhausmortalität betrug in unserem Kollektiv 11,9% und bewegte sich auf dem gleichen Niveau wie in den Vergleichstudien. Die multivariate Analyse der Krankenhausmortalität ergab ein statistisch signifikantes Ergebnis für das Aufnahmehämoglobin und einen Trend für die Transfusion (OR=2,050, p-Wert=0,052). Das Aufnahmehämoglobin zeigte einen hohen negativen prädiktiven Wert für die Krankenhausmortalität. Die Korrelation der Transfusion von Erythrozytenkonzentraten mit dem früheren Eintritt der ersten Infektion, sowie der Trend zu höherer Krankenhausmortalität unterstützen eine restriktive Transfusionsstrategie im prolongierten Weaning. Der optimale Transfusionstrigger im prolongierten Weaning sollte das Ziel zukünftiger randomisierten kontrollierten Studien sein

Variables predicting weaning outcome in prolonged mechanically ventilated tracheotomized patients: a retrospective study

Background: Several studies have assessed predictors of weaning and extubation outcome in short-term mechanically ventilated patients, but there are only few studies on predictors of weaning from prolonged mechanical ventilation. Methods: Retrospective, single-center, observational study at a specialized national weaning center in Germany. Patients' medical records were reviewed to obtain data on demographics, comorbidities, respiratory indices, and the result of a prospectively documented, standardized spontaneous breathing trial (SBT) upon admission to the weaning center. Respiratory indices assessed were the ventilatory ratio (VR) and parameters derived from calculated mechanical power (MP). Predictors associated with failure of prolonged weaning and failure of the SBT were assessed using a binary logistic regression model. Results: A total of 263 prolonged mechanically ventilated, tracheotomized patients, treated over a 5-year period were analyzed. After 3 weeks of mechanical ventilation, patients with unsuccessful weaning failed a SBT more frequently and showed significantly increased values for inspiratory positive airway pressure, driving pressure, VR, absolute MP, and MP normalized to predicted body weight and dynamic lung-thorax compliance (LTC-MP). In the logistic regression analyses, variables independently correlated with weaning failure were female gender (adjusted odds ratio 0.532 95% CI 0.291-0.973; p = 0.040), obesity (body mass index ≥ 30 kg/m2) (2.595 1.210-5.562; p = 0.014), COPD (3.209 1.563-6.589; p = 0.002), LTC-MP (3.470 1.067-11.284; p = 0.039), PaCO2 on mechanical ventilation (1.101 95% CI 1.034-1.173; p = 0.003), and failure of the SBT (4.702 2.250-9.825; p < 0.001). In addition, female gender (0.401 0.216-0.745; p = 0.004), LTC-MP (3.017 1.027-8.862; p = 0.046), and PaCO2 on mechanical ventilation (1.157 1.083-1.235; p < 0.001) were independent risk factors for an unsuccessful SBT. Conclusions In the present study, the derived predictors of weaning point to a crucial role of the workload imposed on respiratory muscles during spontaneous breathing. Mechanical power normalized to lung-thorax compliance was independently correlated with weaning outcome and may identify patients at high risk for weaning failure