Human papillomavirus (HPV) in mothers before and after delivery – a three year follow-up study.

Human papillomavirus (HPV) infections in mothers are important to consider since pregnancy may affect the outcome of the infection and the mother may transmit HPV to the child. This thesis is part of the 3-year Finnish Family HPV Study on HPV infection dynamics within 329 families. The presence of maternal HPV antibodies and HPV DNA in placenta, umbilical cord blood and breast milk was examined. In addition, genital and oral HR-HPV carriage was studied among mothers with one or two pregnancies. At enrollment, seropositivity to HPV 6, 11, 16, 18 and 45 was recorded in 53 %, 21 %, 35 %, 21 % and 9 % of the mothers, respectively. Age at sexual debut, number of sexual partners, a history of genital warts and antibodies to LR/HR-HPV predicted HR/LR-HPV-seropositivity. During follow-up 27 %, 14 %, 17 %, 17 % and 7 % of the mothers seroconverted to the tested HPV-types, respectively. Decay of HPV-antibodies was rare. The mother’s new pregnancy was of minor impact in the outcome of oral and cervical HR-HPV infections. HPV-DNA was present in 4.2 % and 3.5 % of the placentas and umbilical cord blood samples, and in 4.5 % and 19.7 % of the breast milk samples collected at day 3 and month 2 postpartum, respectively. HPV-positivity in placenta/cord blood was related to a history of abnormal pap-smears or genital warts, and raised the risk of the neonate being HPV-positive at birth. The mode of delivery did not predict the HPVstatus of neonate, placenta, or cord blood. HPV DNA in breast milk was associated with oral HPV status of the father, but not with HPV status of the neonate. The results indicate that exposure to HPV is common and that part of the exposure might take place already early in life. Contrary to the common claim, pregnancy is not a risk factor for HPV.

De sale calcis murario

Invocatio: D.A.G.

De sale Sodomitico

Invocatio: D.D.

De sale

Invocatio: Auspice et duce Deo! - Ded.: Petrus Osander, Nicolaus Hahn, Nicolaus Cornerus, Andreas Aquilonius, Johannes Ranckel, Jonas Holtman, Theodorus Abrahamsson, Laurent. Werelinus.

Customer Driven Order-to-Delivery Process

This thesis was made for a large forest industry company’s business segment. The purpose of the study was to improve the performance of the order-to-delivery process of the business segment. The study proceeded in three phases. The first phase was to define customer expectations in the market. The second phase was to analyse the performance and the operations of the order-to-delivery process, and to define any challenges or problems in serving the customers. The third and final phase was improving the performance of the order-to-delivery process, within the scope defined by the first two phases. The analysis showed that the delivery reliability is an essential but a challenging issue in the case company’s markets. On delivery reliability standpoint, the most challenging factors were the detected information flow distortions within the company as well as in the whole supply chain, and the lack of horizontal control over the multi-stage process.

Delivery, Outcome, and Costs of Orthodontic Care in Finnish Health Centres

The goal of the study was to analyse orthodontic care in Finnish health centres with special reference to the delivery, outcome and costs of treatment. Public orthodontic care was studied by two questionnaires sent to the chief dental officers of all health centres (n = 276) and to all specialist orthodontists in Finland (n = 146). The large regional variation was mentioned by the orthodontists as the most important factor requiring improvement. Orthodontic practices and outcome were studied in eight Finnish municipal health centres representing early and late timing of treatment. A random sample of 16- and 18-year-olds (n = 1109) living in these municipalities was examined for acceptability of occlusion with the Occlusal Morphology and Function Index (OMFI). In acceptability of occlusion, only minor differences were found between the two timing groups. The percentage of subjects with acceptable morphology was higher among untreated than among treated adolescents. The costs of orthodontic care were estimated among the adolescents with a treatment history. The mean appliance costs were higher in the late, and the mean visit costs higher in the early timing group. The cost-effectiveness of orthodontic services differed among the health centres, but was almost equal in the two timing groups. National guidelines and delegation of orthodontic tasks were suggested as the tools for reducing the variation among the health centres. In the eight health centres, considerable variation was found in acceptability of occlusion and in cost-effectiveness of services. The cost-effectiveness was not directly connected with the timing of treatment.

Stress testing and risk evaluation of new capacity payment algorithm proposed by Market Council

In the Russian Wholesale Market, electricity and capacity are traded separately. Capacity is a special good, the sale of which obliges suppliers to keep their generating equipment ready to produce the quantity of electricity indicated by the System Operator. The purpose of the formation of capacity trading was the maintenance of reliable and uninterrupted delivery of electricity in the wholesale market. The price of capacity reflects constant investments in construction, modernization and maintenance of power plants. So, the capacity sale creates favorable conditions to attract investments in the energy sector because it guarantees the investor that his investments will be returned.

Applying organizational core values in everyday delivery work - case Accenture

The purpose of this thesis is to study organizational core values and their application in practice. With the help of literature, the thesis discusses the implementation of core values and the benefits that companies can gain by doing it successfully. Also, ways in which companies can improve their values’ application to their everyday work are presented. The case company’s value implementation is evaluated through a survey research conducted on their employees. The true power of values lies in their application, and therefore, core values should be the basis for all organizational behavior, integrated into everything a company does. Applying values in practice is an ongoing process and companies should continuously work towards creating a more value-based organizational culture. If a company does this effectively, they will most likely become more successful with stakeholders as well as financially. Companies looking to turn their values into actions should start with a self-assessment. Employee surveys are effective in assessing the current level of value implementation, since employees have valuable, first-hand information regarding the situations and behaviors they face in their everyday work. After the self-assessment, things like management commitment, communication, training, and support are key success factors in value implementation.

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.

Yrittäjätoiminnan mahdollisuudet puunhankinnassa

Tutkimuksen tarkoitus on tutkia pienyritysten, erityisesti puunkorjuuyritysten, mahdollisuuksia tuottaa entistä monipuolisempia palveluja puunhankintakentässä. Puunkorjuuyritysten lisäksi keskeisessä roolissa tutkimuksessa ovat puunhankintaorganisaatiot ja metsänomistajat (puunmyyjät), jotka joko suoraan tai välillisesti ovat puunkorjuuyritysten asiakkaita. Tutkimuksessa pohditaan puumarkkinakenttää sekä vaihtoehtoisia ja uusia toimintamalleja siten, että niistä olisi kaikille osapuolille hyötyä. Tutkimuksen teoriaosassa käsitellään puumarkkinoiden toimintaa, esitellään nykyiset puukauppatavat, käytössä olevat puunhankinnan toimintamallit, arvoketjuajattelu sekä Porterin viiden kilpailuvoiman malli. Tutkimuksen empiriaosa koostuu haastattelutuloksista sekä niiden analysoinnista. Tutkimuksessa haastateltiin kahdeksaa puunhankintaorganisaation edustajaa. Metsänomistajia edustaa alueellinen metsänomistajajärjestön edustaja. Haastatteluihin valittiin vain Kaakkois-Suomen alueella toimivia organisaatioita. Puunhankintaorganisaatioiden viitoittamien mahdollisuuksien mukaan muodostettiin puunkorjuuyrityksen kannalta mahdollisia toimintavisioita, joista on esitetty myös suuntaa antavia laskelmia. Toimintavisioita on pohdittu myös Porterin viiden kilpailuvoiman avulla.

Design of RFID-system for industrial after-sale service

RFID-tekniikka on radiotaajuudella toimivaa etätunnistusta, jossa hyödynnetään RFID-tunnisteiksi kutsuttuja tageja, sekä RFID-lukijoita. RFID-tekniikan käyttökohteet ovat erittäin laajat. Tässä kandidaatintyössä tutkitaan RFID-tekniikan hyödyntämismahdollisuuksia teollisuuden huoltopalvelusuhteessa. Työ keskittyy huollettavien laitteiden etätunnistamiseen mobiileja RFID-lukijoita hyödyntäen. Laitteiden tiedot noudetaan olemassa olevasta tietokannasta web-käyttöliittymän kautta. Koska laitteet koostuvat pääosin metallista, joudutaan tunnistetyyppien valintaa pohtimaan tarkasti. Metallipinnat sekä nesteet vaikuttavat erittäin negatiivisesti useiden tunnisteiden lukuetäisyyteen. Työssä keskitytään vaadittavan järjestelmän suunnittelemiseen aikaisempia tutkimuksia hyödyntäen, mutta itse järjestelmän toteutus ei kuulu tähän kandidaatintyöhön. Lopussa järjestelmän alustava suunnitelma esitellään.

Ydinprosessikuvaus johtamisen tukena rakennusalan konsernissa

Tämän diplomityön tärkeimpänä tavoitteena on kuvata kohdekonsernin ydinprosessi asiakasrajapinnasta takuutarkastukseen sekä sitä tukevat prosessit riittävällä tarkkuudella. Lisäksi tavoitteena on laatia kuvaamisen pohjalta yksinkertainen työkalu yksittäisten hankkeiden johtamisen sekä sisäisen koulutuksen tarpeisiin. Tavoitteena on työn kautta edistää konsernin strategisten tavoitteiden saavuttamista. Työ jakautuu teoria- ja empiriaosaan. Teoriaosassa luodaan viitekehys työn empiriaosalle. Se pitää sisällään prosessiajattelun ja prosessijohtamisen käsittelyä sekä prosessien kuvaamisen ja niiden suorituskyvyn mittaamisen teoreettista taustaa. Työn empiria- eli käytännön osassa kuvataan konsernin strategian mukainen ydinprosessi ja määritetään siihen porttimallin mukaiset portit sekä niissä tarkastettavat minimivaatimukset. Lisäksi esitellään ydinprosessia tukevia prosesseja ja laaditaan suorituskykymittaristo sekä käsitellään jatkuvaa parantamista konsernissa käytännössä. Käytännön osan lopussa esitellään kuvauksen pohjalta laadittu työkalu sekä sen tuomat mahdollisuudet. Teoriaosa on luonteeltaan kirjallisuustutkimus, joka muodostuu kirjojen ja artikkelien pohjalta. Empiriaosassa on sekä tapaustutkimuksen että konstruktiivisen tutkimuksen piirteitä ja menetelminä siinä on käytetty haastatteluja, palavereita ja havainnointia. Empiriaosassa on hyödynnetty myös konsernin omaa aineistoa. Keskeisimpiä tuloksia ovat ydinprosessin kuvaus sekä sen pohjalta laadittu konsernin tarpeisiin vastaava konkreettinen työkalu. Lisäksi tuloksena voidaan pitää havaittua prosessiajattelun edistymistä konsernissa. Kohdekonsernin ydinprosessi koostuu kuudesta vaiheesta: 1) asiakastarpeiden selvitys/myynti, 2) tarjous- ja sopimusvaihe, 3) suunnittelu, 4) työmaavaihe, 5) ennakkotarkastus- ja luovutusvaihe ja 6) loppuselvitys- ja takuuvaihe. Ydinprosessin vaiheet muodostuvat määriteltyjen porttien kautta ja ne muodostavat konsernin prosessikartan rungon.