Stress testing practices in risk management - Empirical evidence from the Finnish banking and insurance sectors

The main purpose of this study was to analyze how stress tests are used in risk management in the Finnish banking and insurance sectors. In order to enhance understanding of the topic, stress testing was explored in the context of corporate governance and regulato-ry implications of Basel II and Solvency II on stress testing were examined. In addition, the effects of the global financial crisis on stress testing were mapped and the differences in stress testing practices between the banking and insurance sector were discussed. The research method was qualitative case study and it was conducted by interviewing risk managers from ten institutions and a representative from FIN-FSA. Findings pointed out that stress testing practices vary significantly between different institutions. Interesting observations were made in terms of stress testing practices in the banking and insurance sectors. The increasing importance and use of stress tests were recognized as a result of the financial crisis. Stress testing was even considered more like art than science given the amount of challenges it involves. In general, improvements in stress tests were suggested, with an emphasis on stress concentration between different types of risks.

Epidemiology of Cytochrome P450-mediated Drug-Drug Interactions

Drug-drug interactions (DDIs) comprise an important cause of adverse drug reactions leading to excess hospitalizations. Drug metabolism is catalyzed by 75% by cytochrome P450 (CYP) enzymes and thus they are often involved in pharmacokinetic DDIs. In general, DDIs are studied in randomized controlled clinical trials in selected study populations. The overall aim of the present studies was to perform observational pharmacoepidemiological surveys on CYP-mediated DDIs in diseases important at the population level. The prevalence of co-administrations of four prodrugs (losartan, codeine, tramadol, and clopidogrel), three sulphonylureas (glibenclamide, glimepiride, and glipizide), or two statins (lovastatin and simvastatin) with well established agents altering CYP activity, as well as of statins with fibrates, was studied in Finland utilizing data from a university hospital medication database (inpatients) and the National Prescription Register of the Social Insurance Institution of Finland, Kela (outpatients). Clinical consequences of potential DDIs were estimated by reviewing laboratory data, and information from hospital care and cause-of-death registers. Concomitant use of study substrates with interacting medication was detected in up to one fifth of patients in both hospital and community settings. Potential CYP3A4 interactions in statin users did not manifest in clear adverse laboratory values but pharmacodynamic DDIs between statins and fibrates predisposed patients to muscular toxicity. Sulphonylurea DDIs with CYP2C9 inhibitors increased the risk of hypoglycaemia. CYP3A4 inhibitor use with clopidogrel was not associated with significant changes in mortality but non-fatal thrombosis and haemorrhage complications were seen less often in this group. Concomitant administration of atorvastatin with clopidogrel moderately attenuated the antithrombotic effect by clopidogrel. The overall mortality was increased in CYP3A4 inducer and clopidogrel co-users. Atorvastatin used concomitantly with prodrug clopidogrel seems to be beneficial in terms of total and LDL cholesterol concentrations, and overall mortality compared with clopidogrel use without interacting medication. In conclusion, CYP-mediated DDIs are a common and often unrecognized consequence of irrational drug prescribing.

Studies on 68Ga-Based Agents for PET Imaging of Cancer and Inflammation

Studies on ⁶⁸Ga-Based Agents for PET Imaging of Cancer and Inflammation Positron emission tomography (PET) is based on the use of radiolabeled agents and facilitates in vivo imaging of biological processes, such as cancer. Because the detection of cancer is demanding and is often obscured by inflammation, there is a demand for better PET imaging agents. The aim was to preliminarily evaluate new PET agents for imaging cancer and inflammation using experimental models. ⁶⁸Ga-chloride and peptides, ⁶⁸Ga-labeled through 1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid (DOTA), targeting matrix metalloproteinase-9 (MMP-9) were tested for tumor imaging. In addition, a ⁶⁸Ga-DOTA-conjugated peptide targeting vascular adhesion protein-1 (VAP-1), was tested for inflammation imaging. The ⁶⁸Ga-based imaging agents described here showed potential features by passing the essential in vitro tests, proceeding further to preclinical in vivo evaluation and being able to visualize the target. The target uptake and target-to-background ratios of ⁶⁸Ga-based agents were, however, not optimal. ⁶⁸Ga-chloride showed slow clearance caused by its binding to blood transferrin. In the case of ⁶⁸Ga-DOTA-peptides low in vivo stability and/or low lipophilicity led to too rapid blood clearance and urinary excretion. The properties of ⁶⁸Ga-labeled peptides are modifiable, as shown with matrix metalloproteinase-9 targeting ligands. In the conclusion of this PhD thesis, ⁶⁸Ga-based agents for PET imaging of cancer and inflammation could be applied in the development of drugs, earlier diagnostics and following-up of the efficacy of therapies.

Studies on Neuromuscular Blocking Agents and Their Antagonists During Anaesthesia

Neuromuscular blocking agents (NMBAs) are widely used in clinical anaesthesia and emergency medicine. Main objectives are to facilitate endotracheal intubation and to allow surgery by reducing muscle tone and eliminating sudden movements, which may otherwise lead to trauma and complications. The most commonly used NMBAs are non-depolarizing agents with a medium duration of action, such as rocuronium and cisatracurium. They bind to the acetylcholine receptors in the neuromuscular junction, thus inhibiting the depolarization of the postsynaptic (muscular) membrane, which is a prerequisite for muscle contraction to take place. Previously, it has been assumed that nitrous oxide (N2O), which is commonly used in combination with volatile or intravenous anaesthetics during general anaesthesia, has no effect on NMBAs. Several studies have since claimed that N2O in fact does increase the effect of NMBAs when using bolus administration of the relaxant. The effect of N2O on the infusion requirements of two NMBAs (rocuronium and cisatracurium) with completely different molecular structure and pharmacological properties was assessed. A closed-loop feedback controlled infusion of NMBA with duration of at least 90 minutes at a 90% level of neuromuscular block was used. All patients received total intravenous anaesthesia (TIVA) with propofol and remifentanil. In both studies the study group (n=35) received N2O/Oxygen and the control group (n=35) Air/Oxygen. There were no significant differences in the mean steady state infusion requirements of NMBA (rocuronium in Study I; cisatracurium in Study II) between the groups in either study. In Study III the duration of the unsafe period of recovery after reversal of rocuronium-induced neuromuscular block by using neostigmine or sugammadex as a reversal agent was analyzed. The unsafe period of recovery was defined as the time elapsed from the moment of no clinical (visual) fade in the train-of-four (TOF) sequence until an objectively measured TOF-ratio of 0.90 was achieved. The duration of these periods were 10.3 ± 5.5 and 0.3 ± 0.3 min after neostigmine and sugammadex, respectively (P < 0.001). Study IV investigated the possible effect of reversal of a rocuronium NMB by sugammadex on depth of anaesthesia as indicated by the bispectral index and entropy levels in thirty patients. Sugammadex did not affect the level of anaesthesia as determined by EEG-derived indices of anaesthetic depth such as the bispectral index and entropy.

Bonding of Composite Resin to Alumina and Zirconia Ceramics with Special Emphasis on Surface Conditioning and Use of Coupling Agents

Dental oxide ceramics have been inspired by their biocompability and mechanical properties which have made durable all-ceramic structures possible. Clinical longevity of the prosthetic structures is dependent on effective bonding with luting cements. As the initial shear bond strength values can be comparable with several materials and procedures, long-term durability is affected by ageing. Aims of the current study were: to measure the shear bond strength of resin composite-to-ceramics and to evaluate the longevity of the bond; to analyze factors affecting the bond, with special emphasis on: the form of silicatization of the ceramic surface; form of silanization; type of resin primer and the effect of the type of the resin composite luting cement; the effect of ageing in water was studied regarding its effect to the endurance of the bond. Ceramic substrates were alumina and yttrium stabilized zirconia. Ceramic conditioning methods included tribochemical silicatization and use of two silane couplings agents. A commercial silane primer was used as a control silane. Various combinations of conditioning methods, primers and resin cements were tested. Bond strengths were measured by shear bond strength method. The longevity of the bond was generally studied by thermocycling the materials in water. Additionally, in one of the studies thermal cycling was compared with long-term water storaging. Results were analysed statistically with ANOVA and Weibull analysis. Tribochemical treatment utilizing air pressure of 150 kPa resulted shear bond strengths of 11.2 MPa to 18.4 MPa and air pressure of 450 kPa 18.2 MPa to 30.5 MPa, respectively. Thermocycling of 8000 cycles or four years water storaging both decreased shear bond strength values to a range of 3.8 MPa to 7.2 MPa whereas initial situation varied from 16.8. Mpa to 23.0 MPa. The silane used in studies had no statistical significance. The use of primers without 10-MDP resulted spontaneous debonding during thermocycling or shear bond strengths below 5 MPa. As conclusion, the results showed superior long-term bonding with primers containing 10-MDP. Silicatization with silanizing showed improved initial shear bond strength values which considerably decreased with ageing in water. Thermal cycling and water storing for up to four years played the major role in reduction of bond strength, which could be due to thermal fatigue of the bonding interface and hydrolytic degradation of the silane coupled interface.

IT service catalog : a case study of the implementation need in a Pan-Nordic Insurance Company

IT service catalog is an increasingly important issue as many IT organizations have been realizing it as a central communication and visualization tool to bridge the gap between IT and the business. This study reviews relevant literature on IT service catalog and related issues on IT services delivery. Furthermore, the study shows how IT service catalog can enhance IT effectiveness as well as provide more benefits when integrating with Configuration Management Database. In order to analyze whether IT service catalog is needed to be implemented in a Pan-Nordic Insurance Company, this study also investigates the current IT services delivery of a case study. The findings of the study show the problems in the current situation of IT services delivery in the case. The characteristics of IT service catalog are recommended in order to help with the mentioned flaws.

Configuration management process improvement : a case study of a Pan-Nordic insurance company

Configuration management is often seen as an enabler for the main IT Service Management (ITSM) processes such as Incident and Problem management. A decent level of quality of IT configuration data is required in order to carry out routines of these processes. This case study examines the state of configuration management in a multinational organization and aims at identification of methods for its improvement. The author has stayed five months with this company in order to collect different sources of evidence and to make observations. The main source of data for this study is interviews with some of the key employees of the assigned organization who are involved into the ITSM processes. This study concludes the maturity level of the existing configuration management process to be repeatable but intuitive, and outlines the principal requirements for its improvement. A match between the requirements identified in the organization and the requirements stated in the ISO/IEC 20000 standard indicates the possibility of adopting ITIL guidelines as a method for configuration management process improvement. The outcome of the study presents a set of recommendations for improvement that considers the process, the information model and the information system for configuration management in the case organization.

Accountability and corruption : a study into political institutions as referees between principals and agents

Representativ demokrati innebär att medborgare istället för att själv göra beslut i frågor som angår dem, ofta delegerar dylikt beslutsfattande till representanter. Det här betyder att viktiga beslut görs av personer som medborgarna i allmänhet inte känner speciellt väl, och i vars ageranden medborgarna endast har lite insyn. Vanliga medborgare och deras representanter har därtill ofta mycket olika intressen, d.v.s. har olika syn på vad som är viktigt. Representanterna har följaktligen både möjligheter och incitament att missbruka den makt som anförtrotts dem, bl.a. genom korrupt verksamhet. Denna avhandling analyserar mekanismer genom vilka korruption bland representanter kan förebyggas, och (då korrupta handlingar redan ägt rum) upptäckas. Avhandlingen granskar mekanismer som a) ger medborgare och andra ansvarsutkrävare mer information om representanternas målsättningar och ageranden, b) som tvingar representanterna att rättfärdiga sina ageranden gentemot medborgare och andra ansvarsutkrävare, och c) som gör det möjligt för medborgare och andra ansvarsutkrävare att straffa representanter som agerat korrupt. Avhandlingen hävdar att tillämpandet av dylika mekanismer minskar lockelsen för och möjligheterna att engagera sig i korrupta handlingar. Avhandlingen studerar de mekanismer för ansvarsutkrävande som skapas genom politiskt institutionsbyggande. Bl.a. analyseras i vilken grad olika valsystem och typer av maktfördelning gör det möjligt att hålla representanter till svars, och därmed förhindra och upptäcka korruption. Sambandet mellan institutionsbyggande, möjligheter till ansvarsutkrävande och förekomst av korruption studeras på såväl makro- som mikronivå. Studien på makronivå inkluderar ett flertal länder och analyserar sambandet med hjälp av statistisk analys. Studien på mikronivå däremot består av två fallstudier (Österrike och Botswana) och utgör en djupdykning i dessa länders politiska institutioner, möjligheter till ansvarsutkrävande inom ramen för institutionerna, och följder i form av korruption.

Marketing of fire suppression systems: customer value and institutional aspects

The paper studied marketing of automatic fire suppression systems from the perspectives of customer value and institutions. The object of the study was research the special features of the sales and marketing of fire suppression systems, and find some practical applications for sales, and for lobbying of a new fire suppression technology. The theoretical background of the study was in the customer value literature and the theoretical concept of institutional entrepreneurship. The research was conducted as an electronic survey for three different groups of respondents; end customers, solution integrators, and re-sellers. From the answers was gathered generalisations about the customer value assessment and communication of the value related to the sales and marketing processes of the fire suppression systems. In addition, there was observed manners to receive information about the systems, and effects caused by institutions to the decision making of the different parties involved. The findings of the study support companies that are launching a new safety technology to the market focus their marketing, and help to understand institutional forces that are affecting to a safety related product.

Improving the fire retardancy of extruded/coextruded wood-plastic composites

The main objective of this thesis is to study the impact of different mineral fillers and fire retardants on the reaction-to-fire properties of extruded/coextruded wood-plastic composites (WPCs). The impact of additives on the flammability properties of WPCs is studied by cone calorimetry. The studied properties are ignition time, peak heat release rate, total heat release, total smoke production, and mass loss rate. The effects of mineral fillers and fire retardants were found to vary with the type of additive, the type of additive combinations, the amount of additives, as well as the production method of the WPCs. The study shows that talc can be used to improve the properties of extruded WPCs. Especially ignition time, peak heat release rate and mass loss rate were found to be improved significantly by talc. The most significant improvement in the fire retardancy of coextruded WPCs was achieved in combinations of natural graphite and melamine. Ignition time, peak heat release rate and total smoke production were improved essentially. High increase in smoke production was found in samples where the amount of ammonium polyphosphate was 10% or higher. Coextrusion as a structural modification was found as a promising way to improve the flammability properties of composite materials in a cost-effective way.