Operationalizing Supply Chain vs. Supply Chain Competion

Competition is an immensely important area of study in economic theory, business and strategy. It is known to be vital in meeting consumers’ growing expectations, stimulating increase in the size of the market, pushing innovation, reducing cost and consequently generating better value for end users, among other things. Having said that, it is important to recognize that supply chains, as we know it, has changed the way companies deal with each other both in confrontational or conciliatory terms. As such, with the rise of global markets and outsourcing destinations, increased technological development in transportation, communication and telecommunications has meant that geographical barriers of distance with regards to competition are a thing of the past in an increasingly flat world. Even though the dominant articulation of competition within management and business literature rests mostly within economic competition theory, this thesis draws attention to the implicit shift in the recognition of other forms of competition in today’s business environment, especially those involving supply chain structures. Thus, there is popular agreement within a broad business arena that competition between companies is set to take place along their supply chains. Hence, management’s attention has been focused on how supply chains could become more aggressive making each firm in its supply chain more efficient. However, there is much disagreement on the mechanism through which such competition pitching supply chain against supply chain will take place. The purpose of this thesis therefore, is to develop and conceptualize the notion of supply chain vs. supply chain competition, within the discipline of supply chain management. The thesis proposes that competition between supply chains may be carried forward via the use of competition theories that emphasize interaction and dimensionality, hence, encountering friction from a number of sources in their search for critical resources and services. The thesis demonstrates how supply chain vs. supply chain competition may be carried out theoretically, using generated data for illustration, and practically using logistics centers as a way to provide a link between theory and corresponding practice of this evolving competition mode. The thesis concludes that supply chain vs. supply chain competition, no matter the conceptualization taken, is complex, novel and can be very easily distorted and abused. It therefore calls for the joint development of regulatory measures by practitioners and policymakers alike, to guide this developing mode of competition.

Snoring and sleep apnea in children

Snoring is a primary and major clinical symptom of upper airway obstruction during sleep. Sleep-disordered breathing ranges from primary snoring to significant partial upper airway obstruction, and obstructive sleep apnea. Adult snoring and obstructive sleep apnea have been extensively studied, whereas less is known about these disorders in children. Snoring and more severe obstructive sleep apnea have been shown to have a harmful effect on the neurobehavioral development of children, but the mechanisms of this effect remains unknown. Furthermore, the correlation of this effect to objective sleep study parameters remains poor. This study evaluated the prevalence of snoring in preschool-aged children in Finland. Host and environmental risk factors, and neurobehavioral and neurocognitive symptoms of children suffering from snoring or obstructive sleep apnea were also investigated. The feasibility of acoustic rhinometry in young children was assessed. The prevalence and risk factors of snoring (I) were evaluated by a questionnaire. The random sample included 2100 children aged 1-6 years living in Helsinki. All 3- to 6-year-old children whose parents reported their child to snore always, often, or sometimes were categorized as snorers, and invited to participate to the clinical study (II-IV). Non-snoring children whose parents were willing to participate in the clinical study were invited to serve as controls. Children underwent a clinical ear-nose-throat examination. Emotional, behavioral, and cognitive performances were evaluated by Child Behavioral Checklist (CBCL), Wechsler Preschool and Primary Scale of Intelligence (WPPSI-R) and NEPSY-A Developmental Neuropsychological Assessment (NEPSY). Nasal volume was measured by acoustic rhinometry, and nasal resistance by rhinomanometry. Lateral and posteroanterior cephalometry were performed. A standard overnight ambulatory polysomnography was performed in the home environment. Twenty-six healthy children were tested in order to assess the feasibility of acoustic rhinometry in young children (V). Snoring was common in children; 6.3% of children snored always or often, whereas 81.3% snored never or occasionally. No differences were apparent between snorers and non-snorers regarding age, or gender. Pediatric snoring was associated with recurrent upper respiratory infections, otitis media, and allergic rhinitis. Exposure to parental tobacco smoke, especially maternal smoking, was more common among snorers. Rhinitis was more common among children who exposured to tobacco smoke. Overnight polysomnography (PSG) was performed on 87 children; 74% showed no signs of significant upper airway obstruction during sleep. Three children had obstructive apnea/hypopnea index (OAHI) greater than 5/h. Age, gender, or a previous adenoidectomy or tonsillectomy did not correlate with OAHI, whereas tonsillar size did correlate with OAHI. Relative body weight and obesity correlated with none of the PSG parameters. In cephalometry, no clear differences or correlations were found in PSG parameters or between snorers and non-snorers. No correlations were observed between acoustic rhinometry, rhinomanometry, and PSG parameters. Psychiatric symptoms were more frequent in the snoring group than in the nonsnoring group. In particular, anxious and depressed symptoms were more prevalent in the snoring group. Snoring children frequently scored lower in language functions. However, PSG parameters correlated poorly with neurocognitive test results in these children. This study and previous studies indicate that snoring without episodes of obstructive apnea or SpO2 desaturations may cause impairment in behavioral and neurocognitive functions. The mechanism of action remains unknown. Exposure to parental tobacco smoke is more common among snorers than non-snorers, emphasizing the importance of a smoke-free environment. Children tolerated acoustic rhinometry measurements well.

Nupoutuskivun vaikutus vasikan hyvinvointiin

Nupouttamisella tarkoitetaan vasikan sarvenaiheiden tuhoamista sarvien kasvun estämiseksi esimerkiksi kuumapolton avulla. Nykyisin lähes kaikki Suomessa syntyvistä vasikoista nupoutetaan turvallisuusnäkökohtien vuoksi. Suomen eläinlääkintölainsäädännön mukaan riittävät tiedot ja taidot toimenpiteen suorittamiseksi omaava henkilö saa nupouttaa alle neliviikkoisen vasikan. Eläinlääkäri voi jättää tilalle pistoksena tai suun kautta annosteltavaa tulehduskipulääkettä nupoutuskivun hoitoa varten. Nupouttamisen on useissa tutkimuksissa todettu aiheuttavan vasikalle kipua, joka ilmenee muun muassa pakenemisyrityksinä toimenpiteen yhteydessä sekä levottomuutena, sosiaalisen käyttäytymisen vähenemisenä, kohonneena sydämen sykkeenä ja stressihormonien tason nousuna nupoutuksen jälkeen. Tähänastisissa tutkimuksissa nupoutuskipua on tutkittu pisimmillään kahden vuorokauden ajan. Koska kuumapoltolla nupouttaminen saa aikaan syvän palovamman, voidaan olettaa vasikan kokevan useiden päivien ajan kipua, joka vaikuttaa hyvinvointia alentavasti. Nupoutuksen vaikutusta vasikoiden makuukäyttäytymiseen tutkittiin viiden päivän ajan nupoutustoimenpiteen jälkeen olettaen, että useamman päivän mittainen tulehduskipulääkekuuri parantaisi vasikoiden hyvinvointia. Tutkimukseen valittiin satunnaisesti kymmenen sonnivasikkaa (keski-ikä 27± 5,6 vrk). Vasikat satunnaistettiin kahteen hoitoryhmään, joista toiset saivat nupoutuspäivänä ja sen jälkeen ketoprofeenivalmistetta suun kautta yhteensä viiden päivän ajan, ja toiset vastaavasti lumelääkettä. Kaikki vasikat nupoutettiin rauhoitettuina ja paikallispuudutettuina kaasukuumenteista nupoutuskolvia käyttäen. Vasikoita videoitiin kuuden vuorokauden ajan, alkaen vuorokausi ennen nupoutusta. Videoaineisto analysoitiin Cowlog -tietokoneohjelmalla. Vasikoita lääkinneet henkilöt sekä videoiden analysoinnin suorittaja eivät tienneet, kumpaan hoitoryhmään kukin vasikka kuului. Koetilanne oli siis kaksoissokkoutettu. Nupoutuspäivää ei otettu huomioon tuloksissa, koska vasikat nupoutettiin rauhoitettuna. Nupoutustoimenpide lyhensi vasikoiden keskimääräistä yhteenlaskettua makuuaikaa vuorokaudessa 1028,2 ± 23,8 minuutista (päivä ennen nupoutusta) 886,1 ± 23,8 minuuttiin (nupoutuspäivää seuraava päivä). Nupoutuspäivää seuraavana päivänä vasikoiden keskimääräinen kokonaismakuuaika oli tilastollisesti merkittävästi lyhyempi verrattuna kaikkiin muihin päiviin (p<0,05). Tuloksissa oli havaittavissa tilastollinen tendenssi, jonka mukaan lumelääkittyjen vasikoiden makuujaksojen lukumäärä vuorokaudessa (22,7±1,6 kertaa) oli tulehduskipulääkittyihin vasikoihin (17,7±1,6 kertaa) verrattuna suurempi koko seurantajakson aikana (p=0,06). Tulehduskipulääkittyjen vasikoiden makuujaksojen keskimääräinen pituus koko seurantajakson aikana oli merkittävästi suurempi (57,3 ± 3,1 minuuttia) kuin lumelääkittyjen vasikoiden (45,0 ± 3,1 minuuttia) (p=0,02). Nupoutus lyhensi kaikkien vasikoiden päivittäistä kokonaismakuuaikaa, mikä viittaa vasikoiden kokeneen akuuttia kipua tulehduskipulääkityksestä huolimatta. Akuutti kipu ja stressi ilmenivät levottomuutena vasikoiden makuukäyttäytymisessä. Riittävä ja laadukas uni on edellytys vasikan kasvulle ja hyvinvoinnille, mikä tekee aiheesta tärkeän myös taloudellisesta näkökulmasta. Tuloksien perusteella voidaan todeta, että nupoutuksen aiheuttama kipu kestää useita päiviä, mutta jatkotutkimuksia tarvitaan kivunhoitovaihtoehtojen osalta sekä kivun kestosta suuremmalla otannalla.