Patient Seclusion and Restraint Practices in Psychiatric Hospitals - Towards Evidence Based Clinical Nursing

The overall goal of this study was to support evidence based clinical nursing regarding patient seclusion and restraint practices. This was done by ensuring professional competence through innovative learning methods. The data were collected in three phases between March 2007 and May 2009 on acute psychiatric wards. Firstly, psychiatric inpatients’ experiences and suggestions for seclusion and restraint practices were explored (n=30). Secondly, nursing and medical personnel’s perceptions of seclusion and restraint practices were explored (n=27). Thirdly, the impacts of a continuing vocational eLearning course on nurses’ professional competence was evaluated (n=158). Patients’ perspectives received insufficient attention during the seclusion and restraint process. Improvements and alternatives to seclusion and restraint as suggested by the patients focused on essential parts of clinical nursing, but were not extensively adopted. Also nursing and medical personnel thought that patients’ subjective perspective received little attention. Personnel proposed a number of alternatives to seclusion and restraint, and they expressed a need for education and support to adopt these in clinical nursing. Evaluation of impacts of eLearning course on nurses’ professional competence showed no statistical differences between an eLearning group and an education-as-usual group. This dissertation provides evidence based knowledge about the realization of seclusion and restraint practices and the impacts of eLearning course on nurses’ professional competence in psychiatric hospitals. In order to improve clinical nursing the patient perspective must be accentuated. To ensure personnel’s professional competence, there is a need for written clinical guidelines, education and support. Continuing vocational education should bring together written clinical guidelines, ethical and legal issues and the support for personnel. To achieve the ambitious goal of such integration, achievable and affordable educational programmes are required. This, in turn, yields a call for innovative learning methods.

Utilization of Meat and bone meal for energy production

At the end of the 1990s the stock breeding in the Europe was suffering from the animal disease epidemics such as Bovine spongiform encephalopathy (BSE) and foot –and mouth disease. The European Union (EU) tackled to this problem by tightening the legislation of animal by-products. At this point, rendering and fat producing industries faces new challenges, which they have to cope with in a way of trying to find alternatives to their products (animal fats and meat and bone meal). One of the most promising alternatives to utilize these products was to use them in energy production purposes. The purpose of the Thesis was to examine the utilization possibilities of Meat and bone meal (MBM) for energy production. The first part of the Thesis consists of theory part. The theory part includes evaluation of basic properties of MBM as a fertilizer and as a fuel, legislative evaluation and evaluation of different burning techniques. The second part of the Thesis consists of burning tests in Energy laboratory of LUT with different mixtures of peat and MBM. The purpose of the burning tests was to identify co-firing possibilities of peat and MBM and emission- and ash properties for peat and MBM.

Luistonestojärjestelmän ja elektronisen tasauspyörästön suunnittelu ja implementointi hybridityökoneympäristöön

Ympäristörasituksen vähentäminen, tiukkenevat päästörajat ja ehtyvät öljyvarat ovat ajaneet kulkuvälineteollisuuden hakemaan uusia vaihtoehtoja ajoneuvojen energiatehokkuuden kehittämiseksi. Hybriditeknologia tarjoaa ratkaisuja kustannustehokkuuden ja ympäristöystävällisyyden parantamiseksi. Hybriditeknologian yleistyessä myös työkoneympäristössä saadaan paitsi kehitettyä energiatehokkaampia ja pienemmillä käyttökustannuksilla olevia työkoneita, niin myös tuotua siviiliajoneuvoista tuttuja turvallisuusominaisuuksia työkoneympäristöön. Perinteisten diesel-moottorien korvaaminen nopeavasteisilla ja tarkasti säädettävillä sähkömoottoreilla tarjoaa mahdollisuuksia toteuttaa tarkempia ja monipuolisempia säätöjärjestelmiä kuin perinteisessä ympäristössä. Tässä diplomityössä suunnitellaan luistonestojärjestelmä ja elektroninen tasauspyörästö hybridityökoneympäristöön. Järjestelmä voi käyttökohteesta riippuen pienentää huomattavasti käyttökustannuksia ja mahdollistaa uusien sovellusten tuomista markkinoille, kuten esimerkiksi kääntymisen avustaminen differentiaalisella ohjauksella.

Communicative and Anticipatory Decision-Making Supported by Bayesian Networks

The purpose of this research is to draw up a clear construction of an anticipatory communicative decision-making process and a successful implementation of a Bayesian application that can be used as an anticipatory communicative decision-making support system. This study is a decision-oriented and constructive research project, and it includes examples of simulated situations. As a basis for further methodological discussion about different approaches to management research, in this research, a decision-oriented approach is used, which is based on mathematics and logic, and it is intended to develop problem solving methods. The approach is theoretical and characteristic of normative management science research. Also, the approach of this study is constructive. An essential part of the constructive approach is to tie the problem to its solution with theoretical knowledge. Firstly, the basic definitions and behaviours of an anticipatory management and managerial communication are provided. These descriptions include discussions of the research environment and formed management processes. These issues define and explain the background to further research. Secondly, it is processed to managerial communication and anticipatory decision-making based on preparation, problem solution, and solution search, which are also related to risk management analysis. After that, a solution to the decision-making support application is formed, using four different Bayesian methods, as follows: the Bayesian network, the influence diagram, the qualitative probabilistic network, and the time critical dynamic network. The purpose of the discussion is not to discuss different theories but to explain the theories which are being implemented. Finally, an application of Bayesian networks to the research problem is presented. The usefulness of the prepared model in examining a problem and the represented results of research is shown. The theoretical contribution includes definitions and a model of anticipatory decision-making. The main theoretical contribution of this study has been to develop a process for anticipatory decision-making that includes management with communication, problem-solving, and the improvement of knowledge. The practical contribution includes a Bayesian Decision Support Model, which is based on Bayesian influenced diagrams. The main contributions of this research are two developed processes, one for anticipatory decision-making, and the other to produce a model of a Bayesian network for anticipatory decision-making. In summary, this research contributes to decision-making support by being one of the few publicly available academic descriptions of the anticipatory decision support system, by representing a Bayesian model that is grounded on firm theoretical discussion, by publishing algorithms suitable for decision-making support, and by defining the idea of anticipatory decision-making for a parallel version. Finally, according to the results of research, an analysis of anticipatory management for planned decision-making is presented, which is based on observation of environment, analysis of weak signals, and alternatives to creative problem solving and communication.

Käytöstä poistettujen tietokoneiden kustannusedullisin jatkokäsittely puolustusvoimissa

Puolustushallinto on suuri materiaalin käyttäjä ja hankkija, se tuottaa huomattavan määrän atk-romua, joka luokitellaan ongelmajätteeksi. Laitteiden poistaminen jää tulosyksikön vastuulle ja sen on huolehdittava niiden asianmukaisesta jatkokäsittelystä. Tietoteknisten laitteiden hävittämisestä aiheutuvat vuotuiset kulut ovat mittavia, ja tästä syystä vaihtoehtoisia tapoja hävittää materiaalia on pohdittava. Tutkielma esittelee eri jatkokäsittelyprosesseja, joilla käytöstä poistetut tietokoneet voidaan hyötykäyttää ja selvittää kustannusedullisimman vaihtoehdon. Lisäksi tutkimuksessa ilmenee kiertoprosesseista saatavat hyödyt ja haitat. Tutkimusmenetelmänä on kirjallisuustutkimus ja teemahaastattelut. Tutkimuksessa on pyritty lähdeaineiston avulla esittelemään jatkokäsittelyprosesseja yksinkertaisessa muodossa. Kirjallisuuteen ja teemahaastatteluihin perustuen on kartoitettu kustannusedullisin jatkokäsittelyprosessi. Tutkimuksessa ilmeni, kustannusedullisimmaksi vaihtoehdoksi tietokoneiden myynti uusien laitehankintojen yhteydessä. Jatkokäsittelytapa kuitenkin poikkeuksetta vaatii uusien laitteiden hankinnan yhteistyökumppanilta. Tämän vuoksi on tarkasteltava tietokonelaitteiden hintojen kilpailukykyisyys verrattuna muihin laitetoimittajiin.

Painesuodattimen automatisoidun kankaanvaihtolaitteen kehittäminen ja tekninen tuotteistaminen

Tässä työssä tarkastellaan CE-merkintään vaadittavia teknisen tuotteistamisen vaiheita käyttäen esimerkkinä painesuodattimen automatisoidun kankaanvaihtolaitteen suunnitteluprosessia. Työssä selvitetään, mitä vaihtoehtoja on painesuodattimen lisälaitteiden luokitteluksi, että ne saadaan tuotteistettua Euroopan talousalueella (ETA). Esimerkkinä käytettävä kankaanvaihtolaite on suunniteltu käyttäen järjestelmällisen koneensuunnittelun menetelmää. CE-merkinnän vaatima riskianalyysi on tehty laitteelle standardin SFS-EN ISO 12100:2010 mukaisesti. Tuloksena saatu laitteen prototyyppi täyttää pääosin laitteelle asetettavat vaatimukset. Kustannusarvio ylittää kuitenkin toivotun omakustannehinnan valoverhojen suhteellisen kalliin hinnan takia. Kustannusarvion mukaan prototyyppi voidaan kuitenkin valmistaa edullisesti, sillä valoverhot eivät ole pakollisia laitteen toiminnallisissa testeissä. Ennen tuotteistamista valoverhojen korvaamisen mahdollisuutta muulla turvatekniikalla on kuitenkin tutkittava. Suunnitteluvaiheen jälkeen laitteen turvallisuuden voidaan todeta olevan vähintään riittävällä tasolla. Riskianalyysi on kuitenkin päivitettävä dokumentti, ja laitteen turvallisuus täytyy varmistaa prototyyppiä testaamalla. Työn perusteella voidaan todeta, että huomioimalla laitteen mahdollisesti aiheuttamat vaaratilanteet jo tuotesuunnittelun alussa, voidaan tuotekehitysprosessia nopeuttaa. Tunnistamalla vaaratilanteet suunnittelun varhaisessa vaiheessa voidaan vähentää riskien määrää, ja siten tarvetta riskien pienentämiselle. Näin vähennetään rakenteen suunnittelun ja riskianalyysin iterointikierrosten määrää, jolloin myös tuotteistamisprosessi nopeutuu.

Machine vision methods for process measurements in pulping

The papermaking industry has been continuously developing intelligent solutions to characterize the raw materials it uses, to control the manufacturing process in a robust way, and to guarantee the desired quality of the end product. Based on the much improved imaging techniques and image-based analysis methods, it has become possible to look inside the manufacturing pipeline and propose more effective alternatives to human expertise. This study is focused on the development of image analyses methods for the pulping process of papermaking. Pulping starts with wood disintegration and forming the fiber suspension that is subsequently bleached, mixed with additives and chemicals, and finally dried and shipped to the papermaking mills. At each stage of the process it is important to analyze the properties of the raw material to guarantee the product quality. In order to evaluate properties of fibers, the main component of the pulp suspension, a framework for fiber characterization based on microscopic images is proposed in this thesis as the first contribution. The framework allows computation of fiber length and curl index correlating well with the ground truth values. The bubble detection method, the second contribution, was developed in order to estimate the gas volume at the delignification stage of the pulping process based on high-resolution in-line imaging. The gas volume was estimated accurately and the solution enabled just-in-time process termination whereas the accurate estimation of bubble size categories still remained challenging. As the third contribution of the study, optical flow computation was studied and the methods were successfully applied to pulp flow velocity estimation based on double-exposed images. Finally, a framework for classifying dirt particles in dried pulp sheets, including the semisynthetic ground truth generation, feature selection, and performance comparison of the state-of-the-art classification techniques, was proposed as the fourth contribution. The framework was successfully tested on the semisynthetic and real-world pulp sheet images. These four contributions assist in developing an integrated factory-level vision-based process control.

Advanced biofuel production: Engineering metabolic pathways for butanol and propane biosynthesis.

Greenhouse gases emitted from energy production and transportation are dramatically changing the climate of Planet Earth. As a consequence, global warming is affecting the living conditions of numerous plant and animal species, including ours. Thus the development of sustainable and renewable liquid fuels is an essential global challenge in order to combat the climate change. In the past decades many technologies have been developed as alternatives to currently used petroleum fuels, such as bioethanol and biodiesel. However, even with gradually increasing production, the market penetration of these first generation biofuels is still relatively small compared to fossil fuels. Researchers have long ago realized that there is a need for advanced biofuels with improved physical and chemical properties compared to bioethanol and with biomass raw materials not competing with food production. Several target molecules have been identified as potential fuel candidates, such as alkanes, fatty acids, long carbon‐chain alcohols and isoprenoids. The current study focuses on the biosynthesis of butanol and propane as possible biofuels. The scope of this research was to investigate novel heterologous metabolic pathways and to identify bottlenecks for alcohol and alkane generation using Escherichia coli as a model host microorganism. The first theme of the work studied the pathways generating butyraldehyde, the common denominator for butanol and propane biosynthesis. Two ways of generating butyraldehyde were described, one via the bacterial fatty acid elongation machinery and the other via partial overexpression of the acetone‐butanol‐ethanol fermentation pathway found in Clostridium acetobutylicum. The second theme of the experimental work studied the reduction of butyraldehyde to butanol catalysed by various bacterial aldehyde‐reductase enzymes, whereas the final part of the work investigated the in vivo kinetics of the cyanobacterial aldehyde deformylating oxygenase (ADO) for the generation of hydrocarbons. The results showed that the novel butanol pathway, based on fatty acid biosynthesis consisting of an acyl‐ACP thioesterase and a carboxylic acid reductase, is tolerant to oxygen, thus being an efficient alternative to the previous Clostridial pathways. It was also shown that butanol can be produced from acetyl‐CoA using acetoacetyl CoA synthase (NphT7) or acetyl‐CoA acetyltransferase (AtoB) enzymes. The study also demonstrated, for the first time, that bacterial biosynthesis of propane is possible. The efficiency of the system is clearly limited by the poor kinetic properties of the ADO enzyme, and for proper function in vivo, the catalytic machinery requires a coupled electron relay system.

Deinking sludge utilization possibilities: technical, economic, and environmental assessments

This report introduces the ENPI project called “EMIR - Exploitation of Municipal and Industrial Residues” which was executed in a co-operation between Lappeenranta University of Technology (LUT), Saint Petersburg State University of Economics (SPbSUE), Saint Petersburg State Technical University of Plant Polymers (SPbSTUPP) and industrial partners from both Leningrad Region (LR), Russia and Finland. The main targets of the research were to identify the possibilities for deinking sludge management scenarios in co-operation with partner companies, to compare the sustainability of the alternatives, and to provide recommendations for the companies in the Leningrad Region on how to best manage deinking sludge. During the literature review, 24 deinking sludge utilization possibilities were identified, the majority falling under material recovery. Furthermore, 11 potential utilizers of deinking sludge were found within the search area determined by the transportation cost. Each potential utilizer was directly contacted in order to establish cooperation for deinking sludge utilization. Finally, four companies, namely, “Finnsementti” – a cement plant in Finland (S1), “St.Gobian Weber” – a light-weight aggregate plant in Finland (S2), “LSR-Cement” – a cement plant in LR (S3), and “Rockwool” – a stone wool plant in LR (S4) were seen as the most promising partners and were included in the economic and environmental assessments. Economic assessment using cost-benefit analysis (CBA) indicated that substitution of heavy fuel oil with dry deinking sludge in S2 was the most feasible option with a benefit/cost ratio (BCR) of 3.6 when all the sludge was utilized. At the same time, the use of 15% of the total sludge amount (the amount that could potentially be treated in the scenario) resulted in a BCR of only 0.16. The use of dry deinking sludge in the production of cement (S3) is a slightly more feasible option with a BCR of 1.1. The use of sludge in stone wool production is feasible only when all the deinking sludge is used and burned in an existing incineration plant. The least economically feasible utilization possibility is the use of sludge in cement production in Finland (S1) due to the high gate fee charged. Environmental assessment was performed applying internationally recognized life cycle assessment (LCA) methodologies: ISO 14040 and ISO 14044. The results of a consequential LCA stated that only S1 and S2 lead to a reduction of all environmental impacts within the impact categories chosen compared to the baseline scenario where deinking sludge is landfilled. Considering S1, the largest reduction of 13% was achieved for the global warming potential (GWP), whereas for S2, the largest decrease of abiotic depletion potential (ADP) was by 1.7%, the eutrophication potential (EP) by 1.8%, and a GWP of 2.1% was documented. In S3, the most notable increase of ADP and acidification potential (AP) by 2.6 and 1.5% was indicated, while the GWP was reduced by 12%, the largest out of all the impact categories. In S4, ADP and AP increased by 2.3 and 2.1% respectively, whereas ODP was reduced by 25%. During LCA, it was noticed that substitution of fuels causes a greater reduction of environmental impact (S1 and S2) than substitution of raw materials (S3 and S4). Despite a number of economically and environmentally acceptable deinking sludge utilization methods being assessed in the research, evaluation of bottlenecks and communications with companies’ representatives uncovered the fact that the availability of the raw materials consumed, and the risks associated with technological problems resulting from the sludge utilization, limited the willingness of industrial partners to start deinking sludge utilization. The research results are of high value for decision-makers at already existing paper mills since the result provide insights regarding alternatives to the deinking sludge utilization possibilities already applied. Thus, the research results support the maximum economic and environmental value recovery from waste paper utilization.

Ulkoistuksesta luopumisen kannattavuusarviointi panimoalan yrityksessä

Ulkoistaminen on ollut pitkään yhtenä strategisen päätöksenteon osa-alueena, mutta ulkoistuksesta luopuminen on ollut vähemmän esillä. Tämä työ käsittelee lahtelaisen Teerenpeli Panimo & Tislaamo Oy:n yhden logistiikan osa-alueen ulkoistamisen ja ulkoistuksesta luopumisen välistä kannattavuutta. Tällä hetkellä ulkopuolinen yritys vastaa ravintola-astioiden pesu- ja varastointijärjestelyistä. Nyt laajentuneen toiminnan ja kasvaneen kysynnän ansiosta selvitetään ulkoistuksesta luopumisen mahdollisuutta yhtenä tulevaisuuden vaihtoehtona. Vaihtoehtoisia toimintamalleja on kaksi. Ensimmäisessä yritys investoisi omaan pesu- ja täyttöjärjestelmään ja vastaisi myös ravintola-astioiden logistiikasta kokonaisuudessaan. Näin ollen ulkopuolisen toimijan hyödyntäminen ravintolaastioiden logistiikassa jäisi pois. Toinen vaihtoehtoinen malli liittyy äskettäin markkinoilla suosiota saaneisiin niin sanottujen yksisuuntaisten ravintola-astioiden käyttöönottoon. Näitä astioita ei uudelleen pestä lainkaan, vaan käytön jälkeen hävitetään edelleen kierrätettäväksi. Diplomityön lopussa arvioidaan eri mallien välistä kannattavuutta taloudellisin perustein. Tämän lisäksi mallien välistä kannattavuutta arvioidaan taloudellisten mittareiden ulkopuolisilla tekijöillä, esimerkiksi ulkoistuksesta luopumisen vaikutuksia muuhun jäljelle jäävään yhteistyön. Lopussa annetaan myös toimintaohjeet tulevaa varten.