Health-related quality of life in school children: validation of instrument, child self assessment, parent-proxy assessment and school nursing documentation of health check-ups

The aims of this study were to validate an international Health-Related Quality of Life (HRQL) instrument, to describe child self and parent-proxy assessed HRQL at child age 10 to 12 and to compare child self assessments with parent-proxy assessments and school nursing documentation. The study is part of the Schools on the Move –research project. In phase one, a cross-cultural translation and validation process was performed to develop a Finnish version of Pediatric Quality of Life Inventory™ 4.0 (PedsQL™ 4.0). The process included a two-way translation, cognitive interviews (children n=7, parents n=5) and a survey (children n=1097, parents n=999). In phase two, baseline and follow-up surveys (children n=986, parents n=710) were conducted to describe and compare the child self and parent-proxy assessed HRQL in school children between the ages 10 and 12. Phase three included two separate data, school nurse documented patient records (children n=270) and a survey (children n=986). The relation between child self assessed HRQL and school nursing documentation was evaluated. Validity and reliability of the Finnish version of PedsQL™ 4.0 was good (Child Self Report α=0.91, Parent-Proxy Report α=0.88). Children reported lower HRQL scores at the emotional (mean 76/80) than the physical (mean 85/89) health domains and significantly lower scores at the age of 10 than 12 (dMean=4, p=<0.001). Agreement between child self and parent-proxy assessment was fragile (r=0,4, p=<0.001) but increased as the child grew from age 10 to 12 years. At health check-ups, school nurses documented frequently children’s physical health, such as growth (97%) and posture (98/99%) but seldom emotional issues, such as mood (2/7%). The PedsQLTM 4.0 is a valid instrument to assess HRQL in Finnish school children although future research is recommended. Children’s emotional wellbeing needs future attention. HRQL scores increase during ages between childhood and adolescence. Concordance between child self and parent-proxy assessed HRQL is low. School nursing documentation, related to child health check-ups, is not in line with child self assessed HRQL and emotional issues need more attention.

The success factors of the Danish energy service industry

The objective of the research was to understand the success factors of the Danish energy service industry. The research phenomenon was studied greatly but the aim was to examine it from the service logic point of view. The research was threefold and it examined the phenomena from the company, industrial and national levels. The purpose of the multi-level study was to understand all the success factors and to examine how they are combined together. First, the research problem was approached through the literature review. After that, the empirical part of the study was conducted as a case study and the data was collected by theme interviews. The collected data was analyzed through theoretical point of view and compared with earlier studies. This study shows that the most important success factor was the country, because it has affected to the other aspects of the success. Because the actors of the industry are linked together tightly, communication and common understanding of business is essential to the industry success. The new energy technologies do not produce directly added value for the customers. This has sifted energy business towards service business, and the customers have been included in the value creation process.

Modeling and Control of the Power Conversion Unit in a Solid Oxide Fuel Cell Environment

In this doctoral thesis, a power conversion unit for a 10 kWsolid oxide fuel cell is modeled, and a suitable control system is designed. The need for research was identified based on an observation that there was no information available about the characteristics of the solid oxide fuel cell from the perspective of power electronics and the control system, and suitable control methods had not previously been studied in the literature. In addition, because of the digital implementation of the control system, the inherent characteristics of the digital system had to be taken into account in the characteristics of the solid oxide fuel cell (SOFC). The characteristics of the solid oxide fuel cell as well the methods for the modeling and control of the DC/DC converter and the grid converter are studied by a literature survey. Based on the survey, the characteristics of the SOFC as an electrical power source are identified, and a solution to the interfacing of the SOFC in distributed generation is proposed. A mathematical model of the power conversion unit is provided, and the control design for the DC/DC converter and the grid converter is made based on the proposed interfacing solution. The limit cycling phenomenon is identified as a source of low-frequency current ripple, which is found to be insignificant when connected to a grid-tied converter. A method to mitigate a second harmonic originating from the grid interface is proposed, and practical considerations of the operation with the solid oxide fuel cell plant are presented. At the theoretical level, the thesis discusses and summarizes the methods to successfully derive a model for a DC/DC converter, a grid converter, and a power conversion unit. The results of this doctoral thesis can also be used in other applications, and the models and methods can be adopted to similar applications such as photovoltaic systems. When comparing the results with the objectives of the doctoral thesis, we may conclude that the objectives set for the work are met. In this doctoral thesis, theoretical and practical guidelines are presented for the successful control design to connect a SOFC-based distributed generation plant to the utility grid.

Reflexive Space. A Constructionist Model of the Russian Reflexive Marker

This study examines the structure of the Russian Reflexive Marker ( ся/-сь) and offers a usage-based model building on Construction Grammar and a probabilistic view of linguistic structure. Traditionally, reflexive verbs are accounted for relative to non-reflexive verbs. These accounts assume that linguistic structures emerge as pairs. Furthermore, these accounts assume directionality where the semantics and structure of a reflexive verb can be derived from the non-reflexive verb. However, this directionality does not necessarily hold diachronically. Additionally, the semantics and the patterns associated with a particular reflexive verb are not always shared with the non-reflexive verb. Thus, a model is proposed that can accommodate the traditional pairs as well as for the possible deviations without postulating different systems. A random sample of 2000 instances marked with the Reflexive Marker was extracted from the Russian National Corpus and the sample used in this study contains 819 unique reflexive verbs. This study moves away from the traditional pair account and introduces the concept of Neighbor Verb. A neighbor verb exists for a reflexive verb if they share the same phonological form excluding the Reflexive Marker. It is claimed here that the Reflexive Marker constitutes a system in Russian and the relation between the reflexive and neighbor verbs constitutes a cross-paradigmatic relation. Furthermore, the relation between the reflexive and the neighbor verb is argued to be of symbolic connectivity rather than directionality. Effectively, the relation holding between particular instantiations can vary. The theoretical basis of the present study builds on this assumption. Several new variables are examined in order to systematically model variability of this symbolic connectivity, specifically the degree and strength of connectivity between items. In usage-based models, the lexicon does not constitute an unstructured list of items. Instead, items are assumed to be interconnected in a network. This interconnectedness is defined as Neighborhood in this study. Additionally, each verb carves its own niche within the Neighborhood and this interconnectedness is modeled through rhyme verbs constituting the degree of connectivity of a particular verb in the lexicon. The second component of the degree of connectivity concerns the status of a particular verb relative to its rhyme verbs. The connectivity within the neighborhood of a particular verb varies and this variability is quantified by using the Levenshtein distance. The second property of the lexical network is the strength of connectivity between items. Frequency of use has been one of the primary variables in functional linguistics used to probe this. In addition, a new variable called Constructional Entropy is introduced in this study building on information theory. It is a quantification of the amount of information carried by a particular reflexive verb in one or more argument constructions. The results of the lexical connectivity indicate that the reflexive verbs have statistically greater neighborhood distances than the neighbor verbs. This distributional property can be used to motivate the traditional observation that the reflexive verbs tend to have idiosyncratic properties. A set of argument constructions, generalizations over usage patterns, are proposed for the reflexive verbs in this study. In addition to the variables associated with the lexical connectivity, a number of variables proposed in the literature are explored and used as predictors in the model. The second part of this study introduces the use of a machine learning algorithm called Random Forests. The performance of the model indicates that it is capable, up to a degree, of disambiguating the proposed argument construction types of the Russian Reflexive Marker. Additionally, a global ranking of the predictors used in the model is offered. Finally, most construction grammars assume that argument construction form a network structure. A new method is proposed that establishes generalization over the argument constructions referred to as Linking Construction. In sum, this study explores the structural properties of the Russian Reflexive Marker and a new model is set forth that can accommodate both the traditional pairs and potential deviations from it in a principled manner.

The bifurcational behaviour of the spatially distributed Rayleigh equation

At the present work the bifurcational behaviour of the solutions of Rayleigh equation and corresponding spatially distributed system is being analysed. The conditions of oscillatory and monotonic loss of stability are obtained. In the case of oscillatory loss of stability, the analysis of linear spectral problem is being performed. For nonlinear problem, recurrent formulas for the general term of the asymptotic approximation of the self-oscillations are found, the stability of the periodic mode is analysed. Lyapunov-Schmidt method is being used for asymptotic approximation. The correlation between periodic solutions of ODE and PDE is being investigated. The influence of the diffusion on the frequency of self-oscillations is being analysed. Several numerical experiments are being performed in order to support theoretical findings.

Images of the future of privacy: A privacy dynamics framework and a causal layered

The future of privacy in the information age is a highly debated topic. In particular, new and emerging technologies such as ICTs and cognitive technologies are seen as threats to privacy. This thesis explores images of the future of privacy among non-experts within the time frame from the present until the year 2050. The aims of the study are to conceptualise privacy as a social and dynamic phenomenon, to understand how privacy is conceptualised among citizens and to analyse ideal-typical images of the future of privacy using the causal layered analysis method. The theoretical background of the thesis combines critical futures studies and critical realism, and the empirical material is drawn from three focus group sessions held in spring 2012 as part of the PRACTIS project. From a critical realist perspective, privacy is conceptualised as a social institution which creates and maintains boundaries between normative circles and preserves the social freedom of individuals. Privacy changes when actors with particular interests engage in technology-enabled practices which challenge current privacy norms. The thesis adopts a position of technological realism as opposed to determinism or neutralism. In the empirical part, the focus group participants are divided into four clusters based on differences in privacy conceptions and perceived threats and solutions. The clusters are fundamentalists, pragmatists, individualists and collectivists. Correspondingly, four ideal-typical images of the future are composed: ‘drift to low privacy’, ‘continuity and benign evolution’, ‘privatised privacy and an uncertain future’, and ‘responsible future or moral decline’. The images are analysed using the four layers of causal layered analysis: litany, system, worldview and myth. Each image has its strengths and weaknesses. The individualistic images tend to be fatalistic in character while the collectivistic images are somewhat utopian. In addition, the images have two common weaknesses: lack of recognition of ongoing developments and simplistic conceptions of privacy based on a dichotomy between the individual and society. The thesis argues for a dialectical understanding of futures as present images of the future and as outcomes of real processes and mechanisms. The first steps in promoting desirable futures are the awareness of privacy as a social institution, the awareness of current images of the future, including their assumptions and weaknesses, and an attitude of responsibility where futures are seen as the consequences of present choices.

Language of the Future, Language of the PRC –Representations of Putonghua in South China Morning Post

As the national language of the PRC, the world's growing economic power and the sovereign of Hong Kong, Putonghua is a language with multiple facets of relevance for the current Special Administrative Region. This paper seeks to explore and explain different representations of Putonghua in Hong Kong's leading English-language newspaper South China Morning Post in articles published between January 2012 and February 2013. The representations are studied in the context of the different discourses in which they appear, some of which feature language(s) as a central theme and some more marginally. An overview is first presented of the scholarly research on the most important developments in Hong Kong's complex language scene from the beginnings of the colony until present day, with the aim of detecting developments and attitudes with potential relevance or parallels to the context of Putonghua today. The paper then reflects on the media and its role in producing and perpetuating discourses in the society, before turning to more practical considerations on Hong Kong's English and Chinese language media and the role of South China Morning Post in it. The methods used in analysing the discourses are those of discourse analysis, with textual analysis as its starting point, in which close attention is paid to linguistic forms as the concrete representations of meanings in a text. Particularly the immediate contexts of the appearances of the word “Putonghua” in the articles were studied carefully to detect vocabulary, grammar and semantical choices as signs of different discourses, potentially also revealing fundamental underlying assumptions and other “hidden meanings” in the text. Some of the most distinctive discourses in which different representations of Putonghua appeared were the Instrumental value for the individual (in which Putonghua was represented as a form of social capital); Othering of the mainlanders (in which Putonghua served as a concrete marker of distinction); Belonging to China (Putonghua as a symbol of unity); and Cultural distinctiveness of Hong Kong (Putonghua as a threat to Hong Kong's history and culture, as embodied in Cantonese). Some of these discourses were more prominent than others, and for example the discourse of Belonging to China was relatively rarely enacted in Hongkongers' voices. In general, the findings were not surprising in the light of the history, but showed a fair degree of consistency with what has been written earlier about the languages and attitudes towards them in Hong Kong. It has often been noted that Putonghua and its relation with Cantonese is a matter linked with the social identity of the colony and its citizens. While it appeared that there were no strict taboos in the representations of Putonghua in the societal context, the possibility of self-censorship cannot be ruled out as a factor toning down political discourses in the representations.

Quantitative Magnetic Resonance Imaging of the Liver and Heart In Iron Overload

Systemic iron overload (IO) is considered a principal determinant in the clinical outcome of different forms of IO and in allogeneic hematopoietic stem cell transplantation (alloSCT). However, indirect markers for iron do not provide exact quantification of iron burden, and the evidence of iron-induced adverse effects in hematological diseases has not been established. Hepatic iron concentration (HIC) has been found to represent systemic IO, which can be quantified safely with magnetic resonance imaging (MRI), based on enhanced transverse relaxation. The iron measurement methods by MRI are evolving. The aims of this study were to implement and optimise the methodology of non-invasive iron measurement with MRI to assess the degree and the role of IO in the patients. An MRI-based HIC method (M-HIC) and a transverse relaxation rate (R2*) from M-HIC images were validated. Thereafter, a transverse relaxation rate (R2) from spin-echo imaging was calibrated for IO assessment. Two analysis methods, visual grading and rSI, for a rapid IO grading from in-phase and out-of-phase images were introduced. Additionally, clinical iron indicators were evaluated. The degree of hepatic and cardiac iron in our study patients and IO as a prognostic factor in patients undergoing alloSCT were explored. In vivo and in vitro validations indicated that M-HIC and R2* are both accurate in the quantification of liver iron. R2 was a reliable method for HIC quantification and covered a wider HIC range than M-HIC and R2*. The grading of IO was able to be performed rapidly with the visual grading and rSI methods. Transfusion load was more accurate than plasma ferritin in predicting transfusional IO. In patients with hematological disorders, the prevalence of hepatic IO was frequent, opposite to cardiac IO. Patients with myelodysplastic syndrome were found to be the most susceptible to IO. Pre-transplant IO predicted severe infections during the early post-transplant period, in contrast to the reduced risk of graft-versus-host disease. Iron-induced, poor transplantation results are most likely to be mediated by severe infections.

Thermal reactions of the major hydrocarbon components of biomass gasification gas

Gasification of biomass is an efficient method process to produce liquid fuels, heat and electricity. It is interesting especially for the Nordic countries, where raw material for the processes is readily available. The thermal reactions of light hydrocarbons are a major challenge for industrial applications. At elevated temperatures, light hydrocarbons react spontaneously to form higher molecular weight compounds. In this thesis, this phenomenon was studied by literature survey, experimental work and modeling effort. The literature survey revealed that the change in tar composition is likely caused by the kinetic entropy. The role of the surface material is deemed to be an important factor in the reactivity of the system. The experimental results were in accordance with previous publications on the subject. The novelty of the experimental work lies in the used time interval for measurements combined with an industrially relevant temperature interval. The aspects which are covered in the modeling include screening of possible numerical approaches, testing of optimization methods and kinetic modelling. No significant numerical issues were observed, so the used calculation routines are adequate for the task. Evolutionary algorithms gave a better performance combined with better fit than the conventional iterative methods such as Simplex and Levenberg-Marquardt methods. Three models were fitted on experimental data. The LLNL model was used as a reference model to which two other models were compared. A compact model which included all the observed species was developed. The parameter estimation performed on that model gave slightly impaired fit to experimental data than LLNL model, but the difference was barely significant. The third tested model concentrated on the decomposition of hydrocarbons and included a theoretical description of the formation of carbon layer on the reactor walls. The fit to experimental data was extremely good. Based on the simulation results and literature findings, it is likely that the surface coverage of carbonaceous deposits is a major factor in thermal reactions.

Westerners in search of the legendary potion : ayahuasca travel in the borderland between tourism and pilgrimage

The thesis examines the phenomenon most commonly known as “ayahuasca tourism” – i.e. the practice of westerners traveling to South America and partaking in ceremonies in which a powerful entheogenic brew, ayahuasca, is consumed. While this popular phenomenon has been steadily increasing during the last decades, it has, however, been insufficiently studied by scholars. An important question which has not been properly addressed in earlier studies is how ayahuasca tourism relates to the wider occurrence of travel and how it should be perceived with reference to the theoretical frameworks on the subject of travel. Drawing on theories regarding pilgrimage and tourism, the main purpose of this thesis is to examine the relationship between ayahuasca tourism and the broader spectrum of travel. In particular, the study tests the designations “pilgrimage”, “religious tourism” and “spiritual tourism” with reference to ayahuasca tourism. Utilizing earlier literature as well as ayahuasca tourists‟ reports obtained from an Internet forum as a basis for analysis, I search for a suitable terminology to be used for the phenomenon. The study lays special emphasis on the protagonists‟ motivations, experiences and outcomes in order to take note of various aspects of the wide-ranging occurrence of ayahuasca tourism. Key findings indicate that ayahuasca tourism is best understood as a combination of pilgrimage and tourism. On the basis of the analysis I argue that ayahuasca tourism should be labeled as “pilgrimage” and/or “spiritual tourism”, and the tourists respectively as “pilgrims” and/or “spiritual tourists”. The category of “religious tourism/tourist”, on the other hand, turns out to be an inappropriate designation when describing the phenomenon. In general, through my study I show that the results are consistent with the present trend in the study of travel to perceive pilgrimage and tourism as theoretically similar phenomena. The study of ayahuasca tourism serves thus as living proof of contemporary travel, in which the categories of pilgrimage and tourism are often indistinguishable. I suggest that ayahuasca tourism is by no means exceptional on this point, but can rather be used as an illustration of modern travel forms on a general level. Thus, the present study does not only add to the research of ayahuasca tourism, but also provides additional insights into the study of travel.

Asleep or not asleep? Evaluation of the Quality of Patients’ Sleep in Critical Care Nursing

Sleep is important for the recovery of a critically ill patient, as lack of sleep is known to influence negatively a person’s cardiovascular system, mood, orientation, and metabolic and immune function and thus, it may prolong patients’ intensive care unit (ICU) and hospital stay. Intubated and mechanically ventilated patients suffer from fragmented and light sleep. However, it is not known well how non-intubated patients sleep. The evaluation of the patients’ sleep may be compromised by their fatigue and still position with no indication if they are asleep or not. The purpose of this study was to evaluate ICU patients’ sleep evaluation methods, the quality of non-intubated patients’ sleep, and the sleep evaluations performed by ICU nurses. The aims were to develop recommendations of patients’ sleep evaluation for ICU nurses and to provide a description of the quality of non-intubated patients’ sleep. The literature review of ICU patients’ sleep evaluation methods was extended to the end of 2014. The evaluation of the quality of patients’ sleep was conducted with four data: A) the nurses’ narrative documentations of the quality of patients’ sleep (n=114), B) the nurses’ sleep evaluations (n=21) with a structured observation instrument C) the patients’ self-evaluations (n=114) with the Richards-Campbell Sleep Questionnaire, and D) polysomnographic evaluations of the quality of patients’ sleep (n=21). The correspondence of data A with data C (collected 4–8/2011), and data B with data D (collected 5–8/2009) were analysed. Content analysis was used for the nurses’ documentations and statistical analyses for all the other data. The quality of non-intubated patients’ sleep varied between individuals. In many patients, sleep was light, awakenings were frequent, and the amount of sleep was insufficient as compared to sleep in healthy people. However, some patients were able to sleep well. The patients evaluated the quality of their sleep on average neither high nor low. Sleep depth was evaluated to be the worst and the speed of falling asleep the best aspect of sleep, on a scale 0 (poor sleep) to 100 (good sleep). Nursing care was mostly performed while the patients were awake, and thus the disturbing effect was low. The instruments available for nurses to evaluate the quality of patients’ sleep were limited and measured mainly the quantity of sleep. Nurses’ structured observatory evaluations of the quality of patients’ sleep were correct for approximately two thirds of the cases, and only regarding total sleep time. Nurses’ narrative documentations of the patients’ sleep corresponded with patients’ self-evaluations in just over half of the cases. However, nurses documented several dimensions of sleep that are not included in the present sleep evaluation instruments. They could be classified according to the components of the nursing process: needs assessment, sleep assessment, intervention, and effect of intervention. Valid, more comprehensive sleep evaluation methods for nurses are needed to evaluate, document, improve and study patients’ quality of sleep.

Permanent magnet synchronous generator design solution for large directdrive wind turbines: Thermal behavior of the LC DD-PMSG

Wind is one of the most compelling forms of indirect solar energy. Available now, the conversion of wind power into electricity is and will continue to be an important element of energy self-sufficiency planning. This paper is one in a series intended to report on the development of a new type of generator for wind energy; a compact, high-power, direct-drive permanent magnet synchronous generator (DD-PMSG) that uses direct liquid cooling (LC) of the stator windings to manage Joule heating losses. The main param-eters of the subject LC DD-PMSG are 8 MW, 3.3 kV, and 11 Hz. The stator winding is cooled directly by deionized water, which flows through the continuous hollow conductor of each stator tooth-coil winding. The design of the machine is to a large degree subordinate to the use of these solid-copper tooth-coils. Both steady-state and timedependent temperature distributions for LC DD-PMSG were examined with calculations based on a lumpedparameter thermal model, which makes it possible to account for uneven heat loss distribution in the stator conductors and the conductor cooling system. Transient calculations reveal the copper winding temperature distribution for an example duty cycle during variable-speed wind turbine operation. The cooling performance of the liquid cooled tooth-coil design was predicted via finite element analysis. An instrumented cooling loop featuring a pair of LC tooth-coils embedded in a lamination stack was built and laboratory tested to verify the analytical model. Predicted and measured results were in agreement, confirming the predicted satisfactory operation of the LC DD-PMSG cooling technology approach as a whole.

Organization of the marketing communication activities after fusion - the integration and the decision making processes

This master’s thesis was made in order to gain answers to the question of how the integration of the marketing communications and the decision making related to it in a geographically dispersed service organization could be improved in a situation where an organization has gone through a merger. The effects of the organizational design dimensions towards the integration of the marketing communications and the decision making related to it was the main focus. A case study as a research strategy offered a perfect frames for an exploratory study and the data collection was conducted by semi-structured interviews and observing. The main finding proved that from the chosen design dimensions, decentralization, coordination and power, could be found specific factors that in a geographically dispersed organization are affecting the integration of the marketing communications negatively. The effects can be seen mostly in the decision making processes, roles and in the division of responsibility, which are affecting the other dimensions and by this, the integration. In a post-merger situation, the coordination dimension and especially the information asymmetry and the information flow seem to have a largest affect towards the integration of the marketing communications. An asymmetric information distribution with the lack of business and marketing education resulted in low self-assurance and at the end in fragmented management and to the inability to set targets and make independent decisions. As conclusions it can be stated, that with the organizational design dimensions can the effects of a merger towards the integration process of the marketing communications to be evaluated.

Forecasting with social media – Using Facebook likes to predict the results of the 2015 Finnish Parliamentary elections

Already one-third of the human population uses social media on a daily basis. The biggest social networking site Facebook has over billion monthly users. As a result, social media services are now recording unprecedented amount of data on human behavior. The phenomenon has certainly caught the attention of scholars, businesses and governments alike. Organizations around the globe are trying to explore new ways to benefit from the massive databases. One emerging field of research is the use of social media in forecasting. The goal is to use data gathered from online services to predict offline phenomena. Predicting the results of elections is a prominent example of forecasting with social media, but regardless of the numerous attempts, no reliable technique has been established. The objective of the research is to analyze how accurately the results of parliament elections can be forecasted using social media. The research examines whether Facebook “likes” can be effectively used for predicting the outcome of the Finnish parliament elections that took place in April 2015. First a tool for gathering data from Facebook was created. Then the data was used to create an electoral forecast. Finally, the forecast was compared with the official results of the elections. The data used in the research was gathered from the Facebook walls of all the candidates that were running for the parliament elections and had a valid Facebook page. The final sample represents 1131 candidates and over 750000 Facebook “likes”. The results indicate that creating a forecast solely based on Facebook “likes” is not accurate. The forecast model predicted very dramatic changes to the Finnish political landscape while the official results of the elections were rather moderate. However, a clear statistical relationship between “likes” and votes was discovered. In conclusion, it is apparent that citizens and other key actors of the society are using social media in an increasing rate. However, the volume of the data does not directly increase the quality of the forecast. In addition, the study faced several other limitations that should be addressed in future research. Nonetheless, discovering the positive correlation between “likes” and votes is valuable information that can be used in future studies. Finally, it is evident that Facebook “likes” are not accurate enough and a meaningful forecast would require additional parameters.