Corporate Identity and Desired Image Elements as a Basis for Corporate Image Development, Case: Myllykoski Sales

Tutkimuksen päätavoitteena oli auttaa Myllykoski –ryhmää määrittämään, mistä tekijöistä ryhmän uuden myyntiorganisaation, Myllykoski Salesin, tulevaisuuden imagon tulisi koostua. Näin ollen tutkimus pyrki selvittämään Myllykoski –ryhmän yritysidentiteetin nykytilaa ja Myllykoski Salesin toivottuja imagotekijöitä, sekä vertaamaan niiden vastaavuutta. Lisäksi tutkimuksen tavoitteena oli tutkia Myllykoski –ryhmän nykyistä ja toivottua tulevaisuuden imagotilaa. Jotta imagonrakennusprosessi olisi menestyksekäs, rakennettavan imagon ja viestittävien imagotekijöiden tulisi perustua yritysidentiteetin todellisiin tekijöihin. Yritysidentiteetin voidaan määritellä olevan yhtäläinen sisäisten sidosryhmien muodostaman yritysmielikuvan kanssa ja näin ollen nykyinen yritysidentiteetti voidaan paljastaa tutkimalla henkilökunnan mielipiteitä työorganisaatiotaan kohtaan. Näin ollen käsiteltävä tutkimus suoritettiin tekemällä kaksi sähköpostikyselyä, jotka suunnattiin Myllykoski -ryhmän myynti- ja markkinointihenkilökunnalle. Tutkimusten vastausprosentit olivat 71,4 % (johto, 14 lähetettyä kyselyä) ja 51,9 % (muu henkilökunta, 108 lähetettyä kyselyä). Saatuja vastauksia analysoitiin sekä laadullisesti että määrällisesti. Saaduista vastauksista oli selvästi havaittavissa Myllykoski –ryhmän yritysidentiteetin nykytila, nykyinen ja toivottu imagotila, sekä Myllykoski Salesin toivotut imagotekijät. Verrattaessa toivottuja imagotekijöitä ryhmän yritysidentiteettiin havaittiin, että suurin osa halutuista imagotekijöistä vastasi ryhmän identiteetin nykytilan ominaisuuksia ja näin ollen kyseisiä tekijöitä voitaisiin huoletta viestiä rakennettaessa Myllykoski Salesin imagoa. Joidenkin toivottujen imagotekijöiden viestintää tulisi kuitenkin vakavasti harkita, jottei rakennettaisi epärealistista imagoa.

Image and value of product brand in industrial markets: Case Stora Enso Consumer Packaging Boards

TUTKIMUKSEN TAVOITTEET Tutkielman tavoitteena oli luoda ensin yleiskäsitys tuotemerkkimarkkinoinnin roolista teollisilla markkinoilla, sekä suhdemarkkinoinnin merkityksestä teollisessa merkkituotemarkkinoinnissa. Toisena oleellisena tavoitteena oli kuvata teoreettisesti merkkituoteidentiteetin rakenne teollisessa yrityksessä ja sen vaikutukset myyntihenkilöstöön, ja lisäksi haluttiin tutkia tuotemerkkien lisäarvoa sekä asiakkaalle että myyjälle. Identiteetti ja sen vaikutukset, erityisesti imago haluttiin tutkia myös empiirisesti. LÄHDEAINEISTO JA TUTKIMUSMENETELMÄT Tämän tutkielman teoreettinen osuus perustuu kirjallisuuteen, akateemisiin julkaisuihin ja aikaisempiin tutkimuksiin; keskittyen merkkituotteiden markkinointiin, identiteettiin ja imagoon, sekä suhdemarkkinointiin osana merkkituotemarkkinointia. Tutkimuksen lähestymistapa on kuvaileva eli deskriptiivinen ja sekä kvalitatiivinen että kvantitatiivinen. Tutkimus on tapaustutkimus, jossa caseyritykseksi valittiin kansainvälinen pakkauskartonki-teollisuuden yritys. Empiirisen osuuden toteuttamiseen käytettiin www-pohjaista surveytä, jonka avulla tietoja kerättiin myyntihenkilöstöltä case-yrityksessä. Lisäksi empiiristä osuutta laajennettiin tutkimalla sekundäärilähteitä kuten yrityksen sisäisiä kirjallisia dokumentteja ja tutkimuksia. TULOKSET. Teoreettisen ja empiirisen tutkimuksen tuloksena luotiin malli jota voidaan hyödyntää merkkituotemarkkinoinnin päätöksenteon tukena pakkauskartonki-teollisuudessa. Teollisen brandinhallinnan tulee keskittyä erityisesti asiakas-suhteiden brandaukseen – tätä voisi kutsua teolliseksi suhdebrandaukseksi. Tuote-elementit ja –arvot, differointi ja positiointi, sisäinen yrityskuva ja viestintä ovat teollisen brandi-identiteetin peruskiviä, jotka luovat brandi-imagon. Case-yrityksen myyntihenkilöstön tuote- ja yritysmielikuvat osoittautuivat kokonaisuudessaan hyviksi. Paras imago on CKB tuotteilla, kun taas heikoin on WLC tuotteilla. Teolliset brandit voivat luoda monenlaisia lisäarvoja sekä asiakas- että myyjäyritykselle.

Characterisation of pigment particles by scanning electron microscope and image analysis programs

Coating and filler pigments have strong influence to the properties of the paper. Filler content can be even over 30 % and pigment content in coating is about 85-95 weight percent. The physical and chemical properties of the pigments are different and the knowledge of these properties is important for optimising of optical and printing properties of the paper. The size and shape of pigment particles can be measured by different analysers which can be based on sedimentation, laser diffraction, changes in electric field etc. In this master's thesis was researched particle properties especially by scanning electron microscope (SEM) and image analysis programs. Research included nine pigments with different particle size and shape. Pigments were analysed by two image analysis programs (INCA Feature and Poikki), Coulter LS230 (laser diffraction) and SediGraph 5100 (sedimentation). The results were compared to perceive the effect of particle shape to the performance of the analysers. Only image analysis programs gave parameters of the particle shape. One part of research was also the sample preparation for SEM. Individual particles should be separated and distinct in ideal sample. Analysing methods gave different results but results from image analysis programs corresponded even to sedimentation or to laser diffraction depending on the particle shape. Detailed analysis of the particle shape required high magnification in SEM, but measured parameters described very well the shape of the particles. Large particles (ecd~1 µm) could be used also in 3D-modelling which enabled the measurement of the thickness of the particles. Scanning electron microscope and image analysis programs were effective and multifunctional tools for particle analyses. Development and experience will devise the usability of analysing method in routine use.

New Distance Transforms for Gray Level Image Compression

This thesis deals with distance transforms which are a fundamental issue in image processing and computer vision. In this thesis, two new distance transforms for gray level images are presented. As a new application for distance transforms, they are applied to gray level image compression. The new distance transforms are both new extensions of the well known distance transform algorithm developed by Rosenfeld, Pfaltz and Lay. With some modification their algorithm which calculates a distance transform on binary images with a chosen kernel has been made to calculate a chessboard like distance transform with integer numbers (DTOCS) and a real value distance transform (EDTOCS) on gray level images. Both distance transforms, the DTOCS and EDTOCS, require only two passes over the graylevel image and are extremely simple to implement. Only two image buffers are needed: The original gray level image and the binary image which defines the region(s) of calculation. No other image buffers are needed even if more than one iteration round is performed. For large neighborhoods and complicated images the two pass distance algorithm has to be applied to the image more than once, typically 3 10 times. Different types of kernels can be adopted. It is important to notice that no other existing transform calculates the same kind of distance map as the DTOCS. All the other gray weighted distance function, GRAYMAT etc. algorithms find the minimum path joining two points by the smallest sum of gray levels or weighting the distance values directly by the gray levels in some manner. The DTOCS does not weight them that way. The DTOCS gives a weighted version of the chessboard distance map. The weights are not constant, but gray value differences of the original image. The difference between the DTOCS map and other distance transforms for gray level images is shown. The difference between the DTOCS and EDTOCS is that the EDTOCS calculates these gray level differences in a different way. It propagates local Euclidean distances inside a kernel. Analytical derivations of some results concerning the DTOCS and the EDTOCS are presented. Commonly distance transforms are used for feature extraction in pattern recognition and learning. Their use in image compression is very rare. This thesis introduces a new application area for distance transforms. Three new image compression algorithms based on the DTOCS and one based on the EDTOCS are presented. Control points, i.e. points that are considered fundamental for the reconstruction of the image, are selected from the gray level image using the DTOCS and the EDTOCS. The first group of methods select the maximas of the distance image to new control points and the second group of methods compare the DTOCS distance to binary image chessboard distance. The effect of applying threshold masks of different sizes along the threshold boundaries is studied. The time complexity of the compression algorithms is analyzed both analytically and experimentally. It is shown that the time complexity of the algorithms is independent of the number of control points, i.e. the compression ratio. Also a new morphological image decompression scheme is presented, the 8 kernels' method. Several decompressed images are presented. The best results are obtained using the Delaunay triangulation. The obtained image quality equals that of the DCT images with a 4 x 4

Computational Techniques for Spectral Image Analysis

Multispectral images are becoming more common in the field of remote sensing, computer vision, and industrial applications. Due to the high accuracy of the multispectral information, it can be used as an important quality factor in the inspection of industrial products. Recently, the development on multispectral imaging systems and the computational analysis on the multispectral images have been the focus of a growing interest. In this thesis, three areas of multispectral image analysis are considered. First, a method for analyzing multispectral textured images was developed. The method is based on a spectral cooccurrence matrix, which contains information of the joint distribution of spectral classes in a spectral domain. Next, a procedure for estimating the illumination spectrum of the color images was developed. Proposed method can be used, for example, in color constancy, color correction, and in the content based search from color image databases. Finally, color filters for the optical pattern recognition were designed, and a prototype of a spectral vision system was constructed. The spectral vision system can be used to acquire a low dimensional component image set for the two dimensional spectral image reconstruction. The data obtained by the spectral vision system is small and therefore convenient for storing and transmitting a spectral image.

Color ad spectral image assessment using novel quality and fidelity techniques

The ongoing development of the digital media has brought a new set of challenges with it. As images containing more than three wavelength bands, often called spectral images, are becoming a more integral part of everyday life, problems in the quality of the RGB reproduction from the spectral images have turned into an important area of research. The notion of image quality is often thought to comprise two distinctive areas – image quality itself and image fidelity, both dealing with similar questions, image quality being the degree of excellence of the image, and image fidelity the measure of the match of the image under study to the original. In this thesis, both image fidelity and image quality are considered, with an emphasis on the influence of color and spectral image features on both. There are very few works dedicated to the quality and fidelity of spectral images. Several novel image fidelity measures were developed in this study, which include kernel similarity measures and 3D-SSIM (structural similarity index). The kernel measures incorporate the polynomial, Gaussian radial basis function (RBF) and sigmoid kernels. The 3D-SSIM is an extension of a traditional gray-scale SSIM measure developed to incorporate spectral data. The novel image quality model presented in this study is based on the assumption that the statistical parameters of the spectra of an image influence the overall appearance. The spectral image quality model comprises three parameters of quality: colorfulness, vividness and naturalness. The quality prediction is done by modeling the preference function expressed in JNDs (just noticeable difference). Both image fidelity measures and the image quality model have proven to be effective in the respective experiments.

Examining the Role of Rebranding in Perceived Image of a Product Line

The main objective for this study was to explore certain organization’s product line rebranding process and its impact on product line’s perceived image. The case company is a global paper, packaging and forest products company, business segment paper board. The audience explored is one of the company’s major customers, merchant in Germany. The research was performed as a descriptive case study with a purpose to provide longitudinal insight into the product line image and its eventual alteration as a result of the case company’s rebranding process. Mainly qualitative methods were used for conducting the research. The data for the empirical part was collected with a web-based survey at two different points of time; before the rebranded products entered the market and after they had been available approximately six months. The results of this study reveal that the case company has performed well in its attempt to improve product line’s brand image through rebranding. It was found that between the two brand image measurements the product brand image seems to have improved in all of the areas which according to theoretical framework of this study contribute to formation of brand image; brand associations, marketing communications and interpersonal relationships, not forgetting the original platform that initiated the change; technical quality modifications. In other words it may be concluded that as technical quality was brought to a new level, also assessments about the brand image improved respectively.

Eye Fundus Image Analysis for Automatic Detection of Diabetic Retinopathy

Diabetes is a rapidly increasing worldwide problem which is characterised by defective metabolism of glucose that causes long-term dysfunction and failure of various organs. The most common complication of diabetes is diabetic retinopathy (DR), which is one of the primary causes of blindness and visual impairment in adults. The rapid increase of diabetes pushes the limits of the current DR screening capabilities for which the digital imaging of the eye fundus (retinal imaging), and automatic or semi-automatic image analysis algorithms provide a potential solution. In this work, the use of colour in the detection of diabetic retinopathy is statistically studied using a supervised algorithm based on one-class classification and Gaussian mixture model estimation. The presented algorithm distinguishes a certain diabetic lesion type from all other possible objects in eye fundus images by only estimating the probability density function of that certain lesion type. For the training and ground truth estimation, the algorithm combines manual annotations of several experts for which the best practices were experimentally selected. By assessing the algorithm’s performance while conducting experiments with the colour space selection, both illuminance and colour correction, and background class information, the use of colour in the detection of diabetic retinopathy was quantitatively evaluated. Another contribution of this work is the benchmarking framework for eye fundus image analysis algorithms needed for the development of the automatic DR detection algorithms. The benchmarking framework provides guidelines on how to construct a benchmarking database that comprises true patient images, ground truth, and an evaluation protocol. The evaluation is based on the standard receiver operating characteristics analysis and it follows the medical practice in the decision making providing protocols for image- and pixel-based evaluations. During the work, two public medical image databases with ground truth were published: DIARETDB0 and DIARETDB1. The framework, DR databases and the final algorithm, are made public in the web to set the baseline results for automatic detection of diabetic retinopathy. Although deviating from the general context of the thesis, a simple and effective optic disc localisation method is presented. The optic disc localisation is discussed, since normal eye fundus structures are fundamental in the characterisation of DR.

Hypoxia-associated biomarkers in rectal cancer treated by preoperative radiotherapy or chemoradiotherapy

Hypoksiaan liittyvät biologiset merkkiaineet leikkausta edeltävällä sädehoidolla tai kemosädehoidolla hoidetussa peräsuolisyövässä Peräsuolensyöpä on yleinen pahanlaatuinen kasvain. Leikkausta edeltävä sädehoito annetaan yleensä T3-T4-kasvaimille. Tutkimuksella pyrittiin selvittämään, voidaanko kasvaimen hapenpuutteeseen liittyvillä biologisilla merkkiaineilla arvioida peräsuolisyövän ennustetta leikkausta edeltävän sädehoidon tai kemosädehoidon jälkeen. Tällaisia merkkiaineita ovat hapenpuutteen vaikutuksesta aktivoituva HIF-1alfa hiilihappoanhydraasi IX (CA IX), sokerin kuljetukseen solussa osallistuva GLUT-1 sekä solun tukirankaproteiini ezrin. Tutkimukseen otettiin 178 potilasta, jotka olivat saaneet ennen leikkausta lyhyen (n=77) tai pitkän sädehoidon (n=10), pitkän sädehoidon ja solunsalpaajahoidon (n=37) tai ei mitään hoitoa (n=54). Lisäksi osalta leikkausta edeltävää sädehoitoa saaneelta potilaalta tutkittiin hoitoja edeltävät, diagnostiset näytteet (n=80). Tutkimuksessa käytettiin immunehistokemiallisia värjäysmenetelmiä. Kasvaimen regressiota (TRG) arvioitiin pitkän sädehoidon jälkeisistä näytteistä. Leikkausnäytteissä negatiivinen/heikko CA IX intensiteetti liittyi sekä pidempään tautispesifiseen (p=0.034) että tautivapaaseen elinaikaan (p=0.003) ja pitkän sädehoidon jälkeen HIF-1alfa-negatiivisuus pidempään tautispesifiseen (p=0.001) sekä negatiivinen/heikko GLUT-1 pidempään tautivapaaseen elinaikaan (p=0.066). Voimakas ezrin-ilmentymä diagnostisissa näytteissä liittyi lyhyempään tautivapaaseen ja tautispesifiseen (p=0.027 ja p=0.002) ennusteeseen. Monimuuttuja-analyysissä vahva CA IX intensiteetti leikkausnäytteissä ennusti itsenäisesti huonompaa tautivapaata ja tautispesifistä selviytymistä. Erinomainen TRG liittyi negatiiviseen/heikkoon CA IX- (p=0.057), ezrin- (p=0.012) ja GLUT-1 -ilmentymään (p=0.013) leikkausnäytteissä. Kun kaikki neljä merkkiainetta analysoitiin yhdessä monimuuttuja-analyysissä, CA IX intensiteetti leikkausnäytteissä ennusti itsenäisesti tautispesifistä elinaikaa. Voimakas CA IX-ilmentymä leikkausnäytteissä ja positiivinen HIF-1alfa- ja vahva GLUT-1-ilmentymä pitkän sädehoidon jälkeisissä leikkausnäytteissä sekä vahva ezrin-ilmentymä diagnostisissa näytteissä liittyivät epäsuotuisaan ennusteeseen. Monimuuttujaanalyysissä kohtalainen/voimakas CA IX intensiteetti leikkausnäytteissä ennusti itsenäisesti huonompaa tautivapaata ja tautispesifistä elinaikaa. CA IX on vahva biologinen merkkiaine peräsuolisyövässä.

A Technique for Digital Color Image Watermarking Using ICA

With the increase of use of digital media the need for the methods of multimedia protection becomes extremely important. The number of the solutions to the problem from encryption to watermarking is large and is growing every year. In this work digital image watermarking is considered, specifically a novel method of digital watermarking of color and spectral images. An overview of existing methods watermarking of color and grayscale images is given in the paper. Methods using independent component analysis (ICA) for detection and the ones using discrete wavelet transform (DWT) and discrete cosine transform (DCT) are considered in more detail. A novel method of watermarking proposed in this paper allows embedding of a color or spectral watermark image into color or spectral image consequently and successful extraction of the watermark out of the resultant watermarked image. A number of experiments have been performed on the quality of extraction depending on the parameters of the embedding procedure. Another set of experiments included the test of the robustness of the algorithm proposed. Three techniques have been chosen for that purpose: median filter, low-pass filter (LPF) and discrete cosine transform (DCT), which are a part of a widely known StirMark - Image Watermarking Robustness Test. The study shows that the proposed watermarking technique is fragile, i.e. watermark is altered by simple image processing operations. Moreover, we have found that the contents of the image to be watermarked do not affect the quality of the extraction. Mixing coefficients, that determine the amount of the key and watermark image in the result, should not exceed 1% of the original. The algorithm proposed has proven to be successful in the task of watermark embedding and extraction.

Construction Plan Image Service for Mobile Devices

The forthcoming media revolution of exchanging paper documents to digital media in construction engineering requires new tools to be developed. The basis of this bachelor’s thesis was to explore the preliminary possibilities of exporting imagery from a Building Information Modelling –software to a mobile phone on a construction yard. This was done by producing a Web Service which uses the design software’s Application Programming Interface to interact with a structures model in order to produce the requested imagery. While mobile phones were found lacking as client devices, because of limited processing power and small displays, the implementation showed that the Tekla Structures API can be used to automatically produce various types of imagery. Web Services can be used to transfer this data to the client. Before further development the needs of the contractor, benefits for the building master and inspector and the full potential of the BIM-software need to be mapped out with surveys.

Application of Computational Fluid Dynamics in Modeling Blood Flow in Human Thoracic Aorta

The aim of this study was to simulate blood flow in thoracic human aorta and understand the role of flow dynamics in the initialization and localization of atherosclerotic plaque in human thoracic aorta. The blood flow dynamics in idealized and realistic models of human thoracic aorta were numerically simulated in three idealized and two realistic thoracic aorta models. The idealized models of thoracic aorta were reconstructed with measurements available from literature, and the realistic models of thoracic aorta were constructed by image processing Computed Tomographic (CT) images. The CT images were made available by South Karelia Central Hospital in Lappeenranta. The reconstruction of thoracic aorta consisted of operations, such as contrast adjustment, image segmentations, and 3D surface rendering. Additional design operations were performed to make the aorta model compatible for the numerical method based computer code. The image processing and design operations were performed with specialized medical image processing software. Pulsatile pressure and velocity boundary conditions were deployed as inlet boundary conditions. The blood flow was assumed homogeneous and incompressible. The blood was assumed to be a Newtonian fluid. The simulations with idealized models of thoracic aorta were carried out with Finite Element Method based computer code, while the simulations with realistic models of thoracic aorta were carried out with Finite Volume Method based computer code. Simulations were carried out for four cardiac cycles. The distribution of flow, pressure and Wall Shear Stress (WSS) observed during the fourth cardiac cycle were extensively analyzed. The aim of carrying out the simulations with idealized model was to get an estimate of flow dynamics in a realistic aorta model. The motive behind the choice of three aorta models with distinct features was to understand the dependence of flow dynamics on aorta anatomy. Highly disturbed and nonuniform distribution of velocity and WSS was observed in aortic arch, near brachiocephalic, left common artery, and left subclavian artery. On the other hand, the WSS profiles at the roots of branches show significant differences with geometry variation of aorta and branches. The comparison of instantaneous WSS profiles revealed that the model with straight branching arteries had relatively lower WSS compared to that in the aorta model with curved branches. In addition to this, significant differences were observed in the spatial and temporal profiles of WSS, flow, and pressure. The study with idealized model was extended to study blood flow in thoracic aorta under the effects of hypertension and hypotension. One of the idealized aorta models was modified along with the boundary conditions to mimic the thoracic aorta under the effects of hypertension and hypotension. The results of simulations with realistic models extracted from CT scans demonstrated more realistic flow dynamics than that in the idealized models. During systole, the velocity in ascending aorta was skewed towards the outer wall of aortic arch. The flow develops secondary flow patterns as it moves downstream towards aortic arch. Unlike idealized models, the distribution of flow was nonplanar and heavily guided by the artery anatomy. Flow cavitation was observed in the aorta model which was imaged giving longer branches. This could not be properly observed in the model with imaging containing a shorter length for aortic branches. The flow circulation was also observed in the inner wall of the aortic arch. However, during the diastole, the flow profiles were almost flat and regular due the acceleration of flow at the inlet. The flow profiles were weakly turbulent during the flow reversal. The complex flow patterns caused a non-uniform distribution of WSS. High WSS was distributed at the junction of branches and aortic arch. Low WSS was distributed at the proximal part of the junction, while intermedium WSS was distributed in the distal part of the junction. The pulsatile nature of the inflow caused oscillating WSS at the branch entry region and inner curvature of aortic arch. Based on the WSS distribution in the realistic model, one of the aorta models was altered to induce artificial atherosclerotic plaque at the branch entry region and inner curvature of aortic arch. Atherosclerotic plaque causing 50% blockage of lumen was introduced in brachiocephalic artery, common carotid artery, left subclavian artery, and aortic arch. The aim of this part of the study was first to study the effect of stenosis on flow and WSS distribution, understand the effect of shape of atherosclerotic plaque on flow and WSS distribution, and finally to investigate the effect of lumen blockage severity on flow and WSS distributions. The results revealed that the distribution of WSS is significantly affected by plaque with mere 50% stenosis. The asymmetric shape of stenosis causes higher WSS in branching arteries than in the cases with symmetric plaque. The flow dynamics within thoracic aorta models has been extensively studied and reported here. The effects of pressure and arterial anatomy on the flow dynamic were investigated. The distribution of complex flow and WSS is correlated with the localization of atherosclerosis. With the available results we can conclude that the thoracic aorta, with complex anatomy is the most vulnerable artery for the localization and development of atherosclerosis. The flow dynamics and arterial anatomy play a role in the localization of atherosclerosis. The patient specific image based models can be used to diagnose the locations in the aorta vulnerable to the development of arterial diseases such as atherosclerosis.

Shapes and sizes : body image, body dissatisfaction and disordered eating in relation to gender and gender identity

Syftet med denna avhandling var att empiriskt undersöka kroppsbild, kroppsmissnöje och ätstörningssymptom hos vuxna i relation till kön och könsidentitet. Även sexuell kroppsbild studerades. Data samlades in via en populationsbaserad frågeformulärsstudie (11,468 deltagare) samt en intervjustudie med 20 transpersoner. Kvinnor rapporterade mer kroppsmissnöje och ätstörningssymptom än män. Till exempel uppgav mer än hälften av kvinnorna och en tredjedel av männen att de uppfattade sig som mindre attraktiva än de önskade att de var. Mer än hälften av kvinnorna och en tredjedel av männen uppgav sig banta, och självframkallade kräkningar rapporterades av var tionde kvinna och var hundrade man. Könsidentitetskonflikt var associerat med högre nivåer av kroppsnöje och ätstörningssymptom. Majoriteten av de intervjuade transpersonerna rapporterade omfattande missnöje med sina kroppar, särskilt gällande sexuell kroppsbild, samt ätstörningssymptom. Könskorrigering uppgavs i huvudsak lindra kroppsmissnöje och ätstörningssymptom. Vårdpersonal bör vara medveten om att kroppsmissnöje och ätstörningssymptom berör både vuxna kvinnor och män. Missnöje med de sexuella delarna av kroppen förefaller vara relativt vanligt bland vuxna och bör inte förbises. Vårdpersonal som arbetar med transpersoner bör vara medvetna om hur djupt och omfattande dessa personers kroppsmissnöje kan vara, samt uppmärksamma en eventuellt förhöjd risk för ätstörningssymptom. Det är även värt att notera att könskorrigering kan lindra kroppsmissnöje och ätstörningssymptom hos transpersoner.

The Possibilities and Dosimetric Limitations of MLC-Based Intensity-Modulated Radiotherapy Delivery and Optimization Techniques

The use of intensity-modulated radiotherapy (IMRT) has increased extensively in the modern radiotherapy (RT) treatments over the past two decades. Radiation dose distributions can be delivered with higher conformality with IMRT when compared to the conventional 3D-conformal radiotherapy (3D-CRT). Higher conformality and target coverage increases the probability of tumour control and decreases the normal tissue complications. The primary goal of this work is to improve and evaluate the accuracy, efficiency and delivery techniques of RT treatments by using IMRT. This study evaluated the dosimetric limitations and possibilities of IMRT in small (treatments of head-and-neck, prostate and lung cancer) and large volumes (primitive neuroectodermal tumours). The dose coverage of target volumes and the sparing of critical organs were increased with IMRT when compared to 3D-CRT. The developed split field IMRT technique was found to be safe and accurate method in craniospinal irradiations. By using IMRT in simultaneous integrated boosting of biologically defined target volumes of localized prostate cancer high doses were achievable with only small increase in the treatment complexity. Biological plan optimization increased the probability of uncomplicated control on average by 28% when compared to standard IMRT delivery. Unfortunately IMRT carries also some drawbacks. In IMRT the beam modulation is realized by splitting a large radiation field to small apertures. The smaller the beam apertures are the larger the rebuild-up and rebuild-down effects are at the tissue interfaces. The limitations to use IMRT with small apertures in the treatments of small lung tumours were investigated with dosimetric film measurements. The results confirmed that the peripheral doses of the small lung tumours were decreased as the effective field size was decreased. The studied calculation algorithms were not able to model the dose deficiency of the tumours accurately. The use of small sliding window apertures of 2 mm and 4 mm decreased the tumour peripheral dose by 6% when compared to 3D-CRT treatment plan. A direct aperture based optimization (DABO) technique was examined as a solution to decrease the treatment complexity. The DABO IMRT technique was able to achieve treatment plans equivalent with the conventional IMRT fluence based optimization techniques in the concave head-and-neck target volumes. With DABO the effective field sizes were increased and the number of MUs was reduced with a factor of two. The optimality of a treatment plan and the therapeutic ratio can be further enhanced by using dose painting based on regional radiosensitivities imaged with functional imaging methods.