Survival and Quality of Life among Patients with Severe Lower Extremity Peripheral Arterial Disease

Lower extremity peripheral arterial disease (PAD) is associated with decreased functional status, diminished quality of life (QoL), amputation, myocardial infarction, stroke, and death. Nevertheless, public awareness of PAD as a morbid and mortal disease is low. The aim of this study was to assess the incidence of major lower extremity amputation due to PAD, the extent of reamputations, and survival after major lower extremity amputation (LEA) in a population based PAD patient cohort. Furthermore, the aim was to assess the functional capacity in patients with LEA, and the QoL after lower extremity revascularization and major amputation. All 210 amputees due to PAD in 1998–2002 and all 519 revascularized patients in 1998–2003 were explored. 59 amputees alive in 2004 were interviewed using a structured questionnaire of QoL. Two of each amputee age-, gender- and domicile-matched controls filled in and returned postal self-administered QoL questionnaire as well as 231 revascularized PAD patients (the amount of these patients who engaged themselves to the study), and one control person for each patient completed postal self-administered QoL questionnaire. The incidence rate of major LEA was 24.1/100 000 person-years and it was considerably high during the years studied. The one-month mortality rate was 21%, 52% at one-year, and the overall mortality rate was 80%. When comparing the one-year mortality risk of amputees, LEAs were associated with a 7.4-fold annual mortality risk compared with the reference population in Turku. Twenty-two patients (10%) had ipsilateral transversions from BK to AK amputation. Fifty patients (24%) ended up with a contralateral major LEA within two to four amputation operations. Three bilateral amputations were performed at the first major LEA operation. Of the 51 survivors returning home after their first major LEA, 36 (71%) received a prosthesis; (16/36, 44%) and were able to walk both in- and outdoors. Of the 68 patients who were discharged to institutional care, three (4%) had a prosthesis one year after LEA. Both amputees and revascularized patients had poor physical functioning and significantly more depressive symptoms than their controls. Depressive symptoms were more common in the institutionalized amputees than the home-dwelling amputees. The surviving amputees and their controls had similar life satisfaction. The amputees felt themselves satisfied and contented, whether or not they lived in long-term care or at home. PAD patients who had undergone revascularizations had poorer QoL than their controls. The revascularized patients’ responses on their perceived physical functioning gave an impression that these patients are in a declining life cycle and that revascularizations, even when successful, may not be sufficient to improve the overall function. It is possible that addressing rehabilitation issues earlier in the care may produce a more positive functional outcome. Depressive symptoms should be recognized and thoroughly considered at the same time the patients are recovering from their revascularization operation. Also primary care should develop proper follow-up, and community organizations should have exercise groups for those who are able to return home, since they very often live alone. In rehabilitation programs we should consider not only physical disability assessment but also QoL.

Control methods for arc welding power supplies

Welding is one of the most important process of modern industry. Welding technology is used in the manufacture and repair a wide variety of products from different metals and alloys. In this thesis the different aspects of arc welding were discussed, such as stability and control of welding arc, power supplies for arc welding (especially the welding inverters because it is the most modern welding power source). All parameters of power source have influence on the arc parameters and its by-turn influence on quality. The ways of control for arc welding inverter power sources have been considered. Calculations and modeling in Matlab/Simulink were done for PI control method. All parameters of power source have influence on the arc parameters and its by-turn influence on quality.

Simulating the performance of paper machine control

The topic of this thesis is the simulation of a combination of several control and data assimilation methods, meant to be used for controlling the quality of paper in a paper machine. Paper making is a very complex process and the information obtained from the web is sparse. A paper web scanner can only measure a zig zag path on the web. An assimilation method is needed to process estimates for Machine Direction (MD) and Cross Direction (CD) profiles of the web. Quality control is based on these measurements. There is an increasing need for intelligent methods to assist in data assimilation. The target of this thesis is to study how such intelligent assimilation methods are affecting paper web quality. This work is based on a paper web simulator, which has been developed in the TEKES funded MASI NoTes project. The simulator is a valuable tool in comparing different assimilation methods. The thesis contains the comparison of four different assimilation methods. These data assimilation methods are a first order Bayesian model estimator, an ARMA model based on a higher order Bayesian estimator, a Fourier transform based Kalman filter estimator and a simple block estimator. The last one can be considered to be close to current operational methods. From these methods Bayesian, ARMA and Kalman all seem to have advantages over the commercial one. The Kalman and ARMA estimators seems to be best in overall performance.

Design and Analysis of Forward Error Control Coding and Signaling for Guaranteeing QoS in Wireless Broadcast Systems

Broadcasting systems are networks where the transmission is received by several terminals. Generally broadcast receivers are passive devices in the network, meaning that they do not interact with the transmitter. Providing a certain Quality of Service (QoS) for the receivers in heterogeneous reception environment with no feedback is not an easy task. Forward error control coding can be used for protection against transmission errors to enhance the QoS for broadcast services. For good performance in terrestrial wireless networks, diversity should be utilized. The diversity is utilized by application of interleaving together with the forward error correction codes. In this dissertation the design and analysis of forward error control and control signalling for providing QoS in wireless broadcasting systems are studied. Control signaling is used in broadcasting networks to give the receiver necessary information on how to connect to the network itself and how to receive the services that are being transmitted. Usually control signalling is considered to be transmitted through a dedicated path in the systems. Therefore, the relationship of the signaling and service data paths should be considered early in the design phase. Modeling and simulations are used in the case studies of this dissertation to study this relationship. This dissertation begins with a survey on the broadcasting environment and mechanisms for providing QoS therein. Then case studies present analysis and design of such mechanisms in real systems. The mechanisms for providing QoS considering signaling and service data paths and their relationship at the DVB-H link layer are analyzed as the first case study. In particular the performance of different service data decoding mechanisms and optimal signaling transmission parameter selection are presented. The second case study investigates the design of signaling and service data paths for the more modern DVB-T2 physical layer. Furthermore, by comparing the performances of the signaling and service data paths by simulations, configuration guidelines for the DVB-T2 physical layer signaling are given. The presented guidelines can prove useful when configuring DVB-T2 transmission networks. Finally, recommendations for the design of data and signalling paths are given based on findings from the case studies. The requirements for the signaling design should be derived from the requirements for the main services. Generally, these requirements for signaling should be more demanding as the signaling is the enabler for service reception.

Phase voltage control and filtering in a converter-fed single-phase customer-end system of the LVDC distribution network

In recent years, the network vulnerability to natural hazards has been noticed. Moreover, operating on the limits of the network transmission capabilities have resulted in major outages during the past decade. One of the reasons for operating on these limits is that the network has become outdated. Therefore, new technical solutions are studied that could provide more reliable and more energy efficient power distributionand also a better profitability for the network owner. It is the development and price of power electronics that have made the DC distribution an attractive alternative again. In this doctoral thesis, one type of a low-voltage DC distribution system is investigated. Morespecifically, it is studied which current technological solutions, used at the customer-end, could provide better power quality for the customer when compared with the current system. To study the effect of a DC network on the customer-end power quality, a bipolar DC network model is derived. The model can also be used to identify the supply parameters when the V/kW ratio is approximately known. Although the model provides knowledge of the average behavior, it is shown that the instantaneous DC voltage ripple should be limited. The guidelines to choose an appropriate capacitance value for the capacitor located at the input DC terminals of the customer-end are given. Also the structure of the customer-end is considered. A comparison between the most common solutions is made based on their cost, energy efficiency, and reliability. In the comparison, special attention is paid to the passive filtering solutions since the filter is considered a crucial element when the lifetime expenses are determined. It is found out that the filter topology most commonly used today, namely the LC filter, does not provide economical advantage over the hybrid filter structure. Finally, some of the typical control system solutions are introduced and their shortcomings are presented. As a solution to the customer-end voltage regulation problem, an observer-based control scheme is proposed. It is shown how different control system structures affect the performance. The performance meeting the requirements is achieved by using only one output measurement, when operating in a rigid network. Similar performance can be achieved in a weak grid by DC voltage measurement. An additional improvement can be achieved when an adaptive gain scheduling-based control is introduced. As a conclusion, the final power quality is determined by a sum of various factors, and the thesis provides the guidelines for designing the system that improves the power quality experienced by the customer.

Improving Quality of Life of Patients With Schizophrenia In Acute Psychiatric Wards

The overall goal of this study was to identify means by which the quality of life (QoL) of patients with schizophrenia could be improved in acute psychiatric wards. First, subjective QoL of patients (n=35) was explored. Second, two different QoL instruments (EuroQoL-5D, EQ-5D; Quality of Life Enjoyment and Satisfaction Questionnaire Short Form, Q-LES-Q SF) were examined. Third, patients’ (n=35) and nurses’ (n=29) perceptions of nursing interventions to support patients’ QoL were examined. Fourth, the effect of three different patient education methods on patients’ QoL (n=311) was compared. The data were collected during the period 2005-2007. Patients named health, family, leisure activities, work or study, and social relationships most frequently as their important QoL areas. It emerged that patients’ QoL was impaired. Examination of two QoL instruments showed that the EQ-5D has moderate and the Q-LES-Q SF good internal consistency. Moreover, both instruments proved to be reasonably valid and feasible for use with patients with schizophrenia. Altogether six nursing interventions which nurses use to support patients’ QoL, and which should be further developed were identified from nurses’ descriptions: interventions related to care planning, empowering interventions, social interventions, activating interventions, security interventions, and interventions to support physical health. Evaluation of different patient education methods showed that patients’ QoL improved significantly during follow-up. No significant differences between groups were found. In light of the findings it is recommended to assess QoL of patients with schizophrenia as a basis for care planning and care evaluation in clinical settings. Valid and feasible instruments should be used in this assessment. Moreover, it is recommend that nursing interventions should be further developed to better improve patients’ QoL.

The Productivity, Economy and Quality of Welding in the Different Geographical Areas of China - Today and in the Future

This master’s thesis gives out the real situation of the China welding industry and factories nowadays in different geographical areas, in order to inform the Finnish companies who have the willing to find a Chinese welding subcontractor a proper and correct selection concept by analyzing and supplying the information of different scale and form welding factories in different Chinese areas. The first section of this thesis gives out the general situation about the co-operation between China and Finland in the welding industry, also includes the general introduction of the Chinese welding industry. The second section gives out the geographical compartmentalization result of Chinese welding industry, which is where and how many areas will be studied in this thesis. The main body of this thesis is the real information of welding productivity, welding cost, and welding quality in China. All the information was collected from real factories in China by the author. The last section of this thesis is the improvements to the Chinese welding factories that have the willing to become a subcontractor, and the suggestions to the Finnish companies who may find a Chinese welding factory as their subcontractor in future.

Uusintamurtumien ehkäisy kaatumisen aiheuttaman yläraajamurtuman kokeneilla yli 50-vuotiailla henkilöillä

Tarkoitus: Tarkoituksena oli selvittää murtumien tehostetun ehkäisyohjelman vaikutuksia yläraajamurtuman saaneiden yli 50-vuotiaiden henkilöiden elämäntapoihin, murtumien riskitekijöihin, kaatumisiin, kaatumisvammoihin ja elämänlaatuun. Aineisto: 219 yli 50-vuotiasta kotona asuvaa, kaatumisen seurauksena yläraajamurtuman saanutta henkilöä satunnaistettiin koe- (n = 105) ja kontrolliryhmiin (n = 114). Menetelmä: Koeohjelma sisälsi yksilöllisen, yhdessä lääkärin, terveydenhoitajan ja tutkittavan kanssa laaditun hoito- ja kuntoutussuunnitelman sekä kutsun murtumien ehkäisyn koulutusohjelmaan. Kontrolliryhmän tutkittavat saivat kehotuksen hakeutua murtumahoitajan ohjaukseen. Seuranta-aika oli 14 kuukautta. Tulokset analysoitiin ryhmissä tapahtuneina muutoksina alkuja loppumittausten välillä sekä ryhmien välisenä erona muutoksissa. Tulokset: Keskimääräinen luun tiheys lannerangassa lisääntyi koeryhmässä (p<0,001) ja kontrolliryhmässä (p = 0,038), ryhmien välinen ero ei ollut tilastollisesti merkitsevä (p = 0,134). Reisiluun kaulassa luun tiheys ei muuttunut kummassakaan ryhmässä. Päivittäinen kalsiumin saanti lisääntyi koeryhmässä keskimäärin 167 mg (p<0,001) ja kontrolliryhmässä 30 mg (p = 0,475), ryhmien välinen ero oli tilastollisesti merkitsevä (p = 0,031). Kala-ateriat ja päivittäinen D-vitamiinilisä sekä kenkien liukuesteiden säännöllinen käyttö liukkaalla lisääntyivät molemmissa ryhmissä, mutta ryhmien välillä ei ollut eroa. Viiteen tuolilta nousukertaan käytetty aika vähentyi koeryhmässä keskimäärin 0,49 sekuntia (p = 0,185) ja lisääntyi kontrolliryhmässä 0,39 (p = 0,475), ero ryhmien välillä oli tilastollisesti merkitsevä (p = 0,02). Kymmenen metrin kävelyssä ei tapahtunut tulosten keskiarvossa muutoksia kummassakaan ryhmässä. Ortostatismi vähentyi kontrolliryhmässä (p = 0,049), ja masentuneisuus vähentyi koeryhmässä (p = 0,041), mutta ryhmien välillä ei näissä ollut merkitsevää eroa. Osteoporoosilääkkeiden käyttö lisääntyi molemmissa ryhmissä, ryhmien välillä ei ollut eroa. Alkoholin käytössä oli vähäisiä mutta ei merkittäviä muutoksia. Muissa testatuissa muuttujissa, kuten liikunnan viikoittainen määrä, tupakointi, näkökyky, tasapaino ja elämänlaatu, ei ollut merkitseviä muutoksia ryhmissä tai ryhmien välillä. Kaatumisten (koeryhmä 33, kontrolliryhmä 35) ja murtumien (koeryhmä 5 ja kontrolliryhmä 3) määrissä ei myöskään ollut merkitseviä eroja ryhmien välillä. Johtopäätökset: Noin neljällä viidestä kaatumisen seurauksena yläraajamurtuman saaneista, yli 50 vuotta täyttäneistä henkilöistä oli alentunut luun tiheys, ja noin joka toisella oli lisääntynyt kaatumisriski. Kaatumisen riskitekijöiden kliiniset mittaukset olivat nopeita toteuttaa ja auttoivat ehkäisytoimenpiteiden suunnittelussa. Murtuman saaneet olivat motivoituneita murtumien riskitekijöiden selvittämiseen ja myös toteuttamaan annettua lääkehoitoa. Elämäntavoissa helpoimmin toteutuivat muutokset ruokailutottumuksissa. Liikuntatottumuksien muuttaminen sen sijaan onnistui melko huonosti. Ryhmien välillä oli merkitsevä ero ainoastaan kalsiumin päivittäisessä käytössä ja tuolilta nousutestissä. Murtumariskien tunnistaminen, niiden syiden selvittäminen ja toimenpiteiden käynnistäminen riskien vähentämiseksi tulisi kuulua jokaisen pienienergisen murtuman saaneen potilaan kokonaisvaltaiseen hyvään hoitoon.

Orthogonal function method in modelling paper web quality variation

This work is devoted to the analysis of signal variation of the Cross-Direction and Machine-Direction measurements from paper web. The data that we possess comes from the real paper machine. Goal of the work is to reconstruct the basis weight structure of the paper and to predict its behaviour to the future. The resulting synthetic data is needed for simulation of paper web. The main idea that we used for describing the basis weight variation in the Cross-Direction is Empirical Orthogonal Functions (EOF) algorithm, which is closely related to Principal Component Analysis (PCA) method. Signal forecasting in time is based on Time-Series analysis. Two principal mathematical procedures that we used in the work are Autoregressive-Moving Average (ARMA) modelling and Ornstein–Uhlenbeck (OU) process.

Virtuaalisen lajittelujärjestelmän hyödyntäminen postipalveluyrityksen tuotannollisessa prosessissa

Työn tavoitteena oli kehittää toimintoperusteista kustannuslaskentaa soveltamalla laskentamalli, jonka avulla on mahdollista tutkia postipalveluyrityksen tuotannollisen prosessin kokonaistuottavuuden kannalta optimaalista tapaa hyödyntää virtuaalista lajittelujärjestelmää. Kimputuksen osalta syntyi teoreettinen laskentamalli, mutta kuljetusyksiköinnin osalta pyrittiin muodostamaan todellista prosessia mahdollisimman hyvin noudattava malli, jonka tuloksia on helppo tutkia erilaisilla kustannus- ja lähetysparametreillä. Virtuaalisen lajittelujärjestelmän tuotannollisen hyödyntämisen ohella työssä oli tarkoitus toteuttaa alustavaa analyysia siitä, millä tapaa järjestelmän avulla voidaan tuottaa myös muuta lisäarvoa postipalvelutuotannolle. Analyysissa havaittiin alustavia hyödyntämismahdollisuuksia palvelutuotannon kuormitussuunnittelun, osoitelaatusidonnaisten toimintojen sekä postiin jätön ja prosessiin ohjauksen osalta. Ottamatta kantaa hyödyntämismahdollisuuksien toteutettavuuteen analyysin keskeinen tulos oli kuitenkin se, että järjestelmän hyödyntämisen osalta tutkimattomia teitä on vielä lukuisia.

Vuokamallisten kartonkipakkausten laadunvarmistuslaitteiston kehittäminen

Diplomityön tavoitteena oli kehittää vuokamallisille kartonkipakkauksille laadunvarmistuslaitteisto. Kirjallisen osan alussa esiteltiin vuokamallisten kartonkipakkausten valmistusprosessia. Tästä siirryttiin laatuasioihin, jossa tärkeimmät asiat olivat kartonkivuokien valmistuksessa esiintyvät laatupoikkeamat ja konenäkö. Tutkimusosan alussa esitellään Lappeenrannan teknillisessä yliopistossa kehitetty kartonkivuokien valmistuslinjasto. Tämän jälkeen vaatimuslistan pohjalta suunnitellaan kyseiseen linjastoon sopiva automaattinen laadunvalvontalaite, johon sisältyy myös kartonkivuokien siirtolaite. Suunnitteluprosessi aloitettiin koekuvaamalla kartonkivuokia erilaisilla kameroilla ja valaistusmenetelmillä. Koekuvausten perusteella valittiin konenäkölaitteisto. Tämän jälkeen toiminnoista luotiin periaatepiirroksia, joista kehitettiin varsinainen suunnitelma. Työn tuloksena saatiin suunnitelma konenäköön perustuvan automaattisen laadunvalvontalaitteen rakentamiselle.

On the impact of rigorous approaches on the quality of development

Software systems are expanding and becoming increasingly present in everyday activities. The constantly evolving society demands that they deliver more functionality, are easy to use and work as expected. All these challenges increase the size and complexity of a system. People may not be aware of a presence of a software system, until it malfunctions or even fails to perform. The concept of being able to depend on the software is particularly significant when it comes to the critical systems. At this point quality of a system is regarded as an essential issue, since any deficiencies may lead to considerable money loss or life endangerment. Traditional development methods may not ensure a sufficiently high level of quality. Formal methods, on the other hand, allow us to achieve a high level of rigour and can be applied to develop a complete system or only a critical part of it. Such techniques, applied during system development starting at early design stages, increase the likelihood of obtaining a system that works as required. However, formal methods are sometimes considered difficult to utilise in traditional developments. Therefore, it is important to make them more accessible and reduce the gap between the formal and traditional development methods. This thesis explores the usability of rigorous approaches by giving an insight into formal designs with the use of graphical notation. The understandability of formal modelling is increased due to a compact representation of the development and related design decisions. The central objective of the thesis is to investigate the impact that rigorous approaches have on quality of developments. This means that it is necessary to establish certain techniques for evaluation of rigorous developments. Since we are studying various development settings and methods, specific measurement plans and a set of metrics need to be created for each setting. Our goal is to provide methods for collecting data and record evidence of the applicability of rigorous approaches. This would support the organisations in making decisions about integration of formal methods into their development processes. It is important to control the software development, especially in its initial stages. Therefore, we focus on the specification and modelling phases, as well as related artefacts, e.g. models. These have significant influence on the quality of a final system. Since application of formal methods may increase the complexity of a system, it may impact its maintainability, and thus quality. Our goal is to leverage quality of a system via metrics and measurements, as well as generic refinement patterns, which are applied to a model and a specification. We argue that they can facilitate the process of creating software systems, by e.g. controlling complexity and providing the modelling guidelines. Moreover, we find them as additional mechanisms for quality control and improvement, also for rigorous approaches. The main contribution of this thesis is to provide the metrics and measurements that help in assessing the impact of rigorous approaches on developments. We establish the techniques for the evaluation of certain aspects of quality, which are based on structural, syntactical and process related characteristics of an early-stage development artefacts, i.e. specifications and models. The presented approaches are applied to various case studies. The results of the investigation are juxtaposed with the perception of domain experts. It is our aspiration to promote measurements as an indispensable part of quality control process and a strategy towards the quality improvement.

Strike hard, strike sure - Operation Musketeer : British military planning during the Suez Crisis, 1956

Operation Musketeer, a combined joint Anglo-French operation aimed at regaining control of the Suez Canal in 1956, has received much attention from scholars. The most common approach to the crisis has been to examine the political dimension. The political events that led Prime Minister Anthony Eden’s cabinet to decide to use military force against the wishes of their superior American ally and in the face of American economic pressure and a Soviet threat to attack Paris and London with rockets have been analysed thoroughly. This is particularly the case because the ceasefire and eventual withdrawal were an indisputable defeat of British policy in the Middle East. The military operation not only ruined Prime Minister Eden’s career, but it also diminished the prestige of Britain. It was the beginning of the end, some claim. The British Empire would never be the same. As the consequences of using force are generally considered more important than the military operations themselves, very little attention has been paid to the military planning of Operation Musketeer. The difference between the number of publications on Operation Corporate of the Falklands War and Operation Musketeer is striking. Not only has there been little previous research on the military aspects of Musketeer, the conclusions drawn in the existing works have not reached a consensus. Some historians, such as Correlli Barnett, compare Musketeer to the utter failures of the Tudor landings and Gallipoli. Among significant politicians, Winston Churchill, who had retired from the prime ministership only a year before the Suez Crisis, described the operation as “the most ill-conceived and ill-executed imaginable”. Colin McInnes, a well-known author on British defence policy, represents the middle view when he describes the execution as “far from failure”. Finally, some, like Julian Thompson, the Commander of 3 Commando Brigade during the Falklands War, rate the military action itself as being successful. The interpretation of how successful the handling of the Suez Crisis was from the military point of view depends very much on the approach taken and the areas emphasised in the subject. Frequently, military operations are analysed in isolation from other events. The action of a country’s armed forces is separated from the wider context and evaluated without a solid point of comparison. Political consequences are often used as validated criteria, and complicated factors contributing to military performance are ignored. The lack of comprehensive research on the military action has left room for an analysis concentrating on the military side of the crisis.

Process approach in quality management - Case: ECO process development in EMS industry

The aim of the thesis was to study quality management with process approach and to find out how to utilize process management to improve quality. The operating environment of organizations has changed. Organizations are focusing on their core competences and networking with suppliers and customers to ensure more effective and efficient value creation for the end customer. Quality management is moving from inspection of the output to prevention of problems from occurring in the first place and management thinking is changing from functional approach to process approach. In the theoretical part of the thesis, it is studied how to define quality, how to achieve good quality, how to improve quality, and how to make sure the improvement goes on as never ending cycle. A selection of quality tools is introduced. Process approach to quality management is described and compared to functional approach, which is the traditional way to manage operations and quality. The customer focus is also studied, and it is presented, that to ensure long term customer commitment, organization needs to react to changing customer requirements and wishes by constantly improving the processes. In the experimental part the theories are tested in a process improvement business case. It is shown how to execute a process improvement project starting from defining the customer requirements, continuing to defining the process ownership, roles and responsibilities, boundaries, interfaces and the actual process activities. The control points and measures are determined for the process, as well as the feedback and corrective action process, to ensure continual improvement can be achieved and to enable verification that customer requirements are fulfilled.

Hazard Risk Management in Large Nordic Companies' Operations in Russia

The objective of this research was to describe how Nordic companies manage hazard risks in their operations in Russia and how the local business environment is considered to affect the hazard risks. Research methods used in this research were literature review and expert interviews. Twelve Nordic industrial companies operating in different fields of industry were interviewed. Large Nordic companies typically guide risk management centralized from the parent company on behalf of the whole company group and the risk management standards and policies are integrated in all subsidiaries. Parent companies typically control hazard risk management in Russia by regular risk management reporting, auditing the Russian sites and by training local managers and employees to risk management work. Many companies have experienced several losses in the first years of operating in Russia before the risk management policies have been implemented in Russian subsidiaries. The companies have learned to take local characteristics better into account by experience and most companies are quite satisfied with their current risk management standards in Russia. The interviews indicate that companies experience especially the poor quality of infrastructure, some features in Russian organizational culture and high level of criminality to increase hazard risks in Russia. However, understanding these features and risks in the business environment makes the management of these risks possible. Risks related to infrastructure can be managed in advance by decreasing dependencies of infrastructure and considering the infrastructure quality already when planning the business operations. Also good local network is often considered critical in order to overcome the complications related to infrastructure. Russian personnel has typically different attitude towards risk management than Nordic personnel and neglecting safety and maintenance and concealing losses is more typical in Russia. By training and guiding the local personnel risk management and safety work and desired ways of actions these risks can be decreased. Criminality risks are often managed to certain extent by investing in security, increasing supervising and paying attention to reliability of the employees and other interest groups of the company.