Clinical Learning Environment and Supervision. Development and Validation of the CLES Evaluation Scale

The purpose of the study is: (1) to describe how nursing students' experienced their clinical learning environment and the supervision given by staff nurses working in hospital settings; and (2) to develop and test an evaluation scale of Clinical Learning Environment and Supervision (CLES). The study has been carried out in different phases. The pilot study (n=163) explored the association between the characteristics of a ward and its evaluation as a learning environment by students. The second version of research instrument (which was developed by the results of this pilot study) were tested by an expert panel (n=9 nurse teachers) and test-retest group formed by student nurses (n=38). After this evaluative phase, the CLES was formed as the basic research instrument for this study and it was tested with the Finnish main sample (n=416). In this phase, a concurrent validity instrument (Dunn & Burnett 1995) was used to confirm the validation process of CLES. The international comparative study was made by comparing the Finnish main sample with a British sample (n=142). The international comparative study was necessary for two reasons. In the instrument developing process, there is a need to test the new instrument in some other nursing culture. Other reason for comparative international study is the reflecting the impact of open employment markets in the European Union (EU) on the need to evaluate and to integrate EU health care educational systems. The results showed that the individualised supervision system is the most used supervision model and the supervisory relationship with personal mentor is the most meaningful single element of supervision evaluated by nursing students. The ward atmosphere and the management style of ward manager are the most important environmental factors of the clinical ward. The study integrates two theoretical elements - learning environment and supervision - in developing a preliminary theoretical model. The comparative international study showed that, Finnish students were more satisfied and evaluated their clinical placements and supervision with higher scores than students in the United Kingdom (UK). The difference between groups was statistical highly significant (p= 0.000). In the UK, clinical placements were longer but students met their nurse teachers less frequently than students in Finland. Arrangements for supervision were similar. This research process has produced the evaluation scale (CLES), which can be used in research and quality assessments of clinical learning environment and supervision in Finland and in the UK. CLES consists of 27 items and it is sub-divided into five sub-dimensions. Cronbach's alpha coefficient varied from high 0.94 to marginal 0.73. CLES is a compact evaluation scale and user-friendliness makes it suitable for continuing evaluation.

Comparison of human and computer-based selective cleaning

Abstract

A decision support system for selective cleaning

[Abstract]

Validation Studies of Thermal-hydraulic Code for Safety Analysis of Nuclear Power Plants

This thesis gives an overview of the validation process for thermal hydraulic system codes and it presents in more detail the assessment and validation of the French code CATHARE for VVER calculations. Three assessment cases are presented: loop seal clearing, core reflooding and flow in a horizontal steam generator. The experience gained during these assessment and validation calculations has been used to analyze the behavior of the horizontal steam generator and the natural circulation in the geometry of the Loviisa nuclear power plant. The cases presented are not exhaustive, but they give a good overview of the work performed by the personnel of Lappeenranta University of Technology (LUT). Large part of the work has been performed in co-operation with the CATHARE-team in Grenoble, France. The design of a Russian type pressurized water reactor, VVER, differs from that of a Western-type PWR. Most of thermal-hydraulic system codes are validated only for the Western-type PWRs. Thus, the codes should be assessed and validated also for VVER design in order to establish any weaknesses in the models. This information is needed before codes can be used for the safety analysis. Theresults of the assessment and validation calculations presented here show that the CATHARE code can be used also for the thermal-hydraulic safety studies for VVER type plants. However, some areas have been indicated which need to be reassessed after further experimental data become available. These areas are mostly connected to the horizontal stem generators, like condensation and phase separation in primary side tubes. The work presented in this thesis covers a large numberof the phenomena included in the CSNI code validation matrices for small and intermediate leaks and for transients. Also some of the phenomena included in the matrix for large break LOCAs are covered. The matrices for code validation for VVER applications should be used when future experimental programs are planned for code validation.

Tuotantolaitteiden kvalifiointi ja prosessin validointi GMP-tuotantoa varten

GMP-säädösten mukaan aktiivisten lääkeaineiden, kriittisten lääkeaineintermediaattien ja lääkeapuaineiden valmistusprosessit pitää validoida. Validointityöhön kuuluu oleellisesti tuotantolaitteiden kvalifiointi ja prosessin validointi. Käytännössä tuotantolaitteiden kvalifiointi toteutetaan tekemällä laitteille suunnitelmien tarkastus (DQ), asennus- ja käyttöönottotarkastus (IQ), toiminnan testaus (OQ) sekä suorituskykytestit (PQ). Tuotantolaitteiden kvalifiointiin kuuluu myös laitteiden asianmukaisten kalibrointi-, kunnossapito- ja puhdistusohjeiden sekä työ- ja toimintaohjeiden (SOP:ien) laatiminen. Prosessin validoinnissa laaditaan dokumentoidut todisteet siitä, että prosessi toimii vakaasti ja tuotteelle asetetut vaatimukset täyttyvät johdonmukaisesti. GMP-tuotantolaitteiden kvalifiointiin ja lääkevalmistusprosessin validointiin on laadittu erilaisia GMP-säädöksiä noudattavia yleisiä validointiohjeita, kuten PIC/S:n ja FDA:n ohjeet kvalifioinnista ja validoinnista. IVT/SC on laatinut yksiselitteiset validointistandardit validointityön selventämiseksi. Validoinnin tilastolliseen tarkasteluun on käytettävissä GHTF:n laatimat tilastolliset validointimenetelmät. Yleensä tuotantolaitteiden kvalifiointi ja prosessin validointi tehdään ennen lääkevalmisteen kaupallisen tuotannon aloittamista. Kvalifiointi- ja validointityö voidaan tehdä kuitenkin myös tuotannon yhteydessä (konkurrentisti) tai retrospektiivisesti käyttäen hyväksi valmistettujen tuotantoerien prosessitietoja. Tässä työssä laadittiin Kemira Fine Chemicals Oy:n Kokkolan GMP-tuotantolinjan lääkeaineintermediaattiprosessin validoinnin yleissuunnitelma (VMP), joka sisältää sekä tuotantolaitteiden kvalifiointisuunnitelman että prosessin validointisuunnitelman. Suunnitelmissa huomioitiin tuotantolaitteiden aikaisempi käyttö muuhun hienokemikaalituotantoon ja tuotantolinjan muuttaminen GMP-vaatimusten mukaiseksi. Työhön kuului myös tuotantolaitteiden kvalifiointityön tekeminen laaditun suunnitelman mukaisesti.

Benchmarked Quality Measurement Process in a Software Validation Process

Jatkuva laadunmittaus osana ohjelmistoprosessia on yleistynyt ohjelmistoyritysten keskuudessa viime vuosien aikana. ISO 9001:2000 -laatustandardi vaatii yrityksiltä tuotteiden ja prosessien laadun mittaamista ja seuraamista. Laadun mittareiden valinta on haastava tehtävä. Yritykset luulevat usein mittaavansa laatua, vaikka ne todellisuudessa mittaavatkin ohjelmistojen eri ominaisuuksia kuten kokoa tai monimutkaisuutta. Tässä diplomityössä kehitetään ohjelmistojen validointiprosessiin vertailuun perustuva laadunmittausprosessi ohjelmistotuotteiden laadun arviointiin, mittaamiseen ja seurantaan. Laatumittarit valitaan ennalta määriteltyjen kriteereiden mukaisesti, ja niille asetetaan tavoitearvot vertailuanalyysistä saatujen tulosten perusteella. Laadunmittausprosessin lisäksi työssä annetaan suositus prosessin käyttöönotosta ja käytöstä osana yrityksen toimintaa, mikä mahdollistaa jatkuvan seurannan sekä kehityksen tulevaisuudessa.

Validation of plant dynamic model by online and laboratory measurements – a tool to predict online COD loads out of production of mechanical printing papers

COD discharges out of processes have increased in line with elevating brightness demands for mechanical pulp and papers. The share of lignin-like substances in COD discharges is on average 75%. In this thesis, a plant dynamic model was created and validated as a means to predict COD loading and discharges out of a mill. The assays were carried out in one paper mill integrate producing mechanical printing papers. The objective in the modeling of plant dynamics was to predict day averages of COD load and discharges out of mills. This means that online data, like 1) the level of large storage towers of pulp and white water 2) pulp dosages, 3) production rates and 4) internal white water flows and discharges were used to create transients into the balances of solids and white water, referred to as “plant dynamics”. A conversion coefficient was verified between TOC and COD. The conversion coefficient was used for predicting the flows from TOC to COD to the waste water treatment plant. The COD load was modeled with similar uncertainty as in reference TOC sampling. The water balance of waste water treatment was validated by the reference concentration of COD. The difference of COD predictions against references was within the same deviation of TOC-predictions. The modeled yield losses and retention values of TOC in pulping and bleaching processes and the modeled fixing of colloidal TOC to solids between the pulping plant and the aeration basin in the waste water treatment plant were similar to references presented in literature. The valid water balances of the waste water treatment plant and the reduction model of lignin-like substances produced a valid prediction of COD discharges out of the mill. A 30% increase in the release of lignin-like substances in the form of production problems was observed in pulping and bleaching processes. The same increase was observed in COD discharges out of waste water treatment. In the prediction of annual COD discharge, it was noticed that the reduction of lignin has a wide deviation from year to year and from one mill to another. This made it difficult to compare the parameters of COD discharges validated in plant dynamic simulation with another mill producing mechanical printing papers. However, a trend of moving from unbleached towards high-brightness TMP in COD discharges was valid.

Cleaning of ceramic filter plates

In this thesis, cleaning of ceramic filter plates clogged by iron oxides was studied. Oxalic acid is considered as the most effective cleaning agent for the plates fouled by iron oxides, but when using oxalic acid, sparingly soluble calcium oxalate may be formed and it can blind the filter media. Suitability of another chemical for cleaning the plates clogged by iron oxides was studied in this thesis. The literature part was mostly about the properties of the chemical, about its reactions, industrial uses, safety issues etc. In the experimental part, the efficiency of the chemical for cleaning of the ceramic plates clogged by iron oxides was studied. Two kinds of plates were used in the experiments; the others were clogged by hematite and the others by magnetite. Both soaking and flow-through experiments were done. A suitable concentration, pH and temperature were tried to find in the experiments. Also the effect of ultrasound was studied. The efficiency of the cleaning was examined by measuring the permeability of the plates during the experiments. ICP-OES analysis was performed for determining the amount of dissolved iron in the washing solution. Some experiments were also done with oxalic acid. The results from the oxalic acid experiments were compared to the results from the experiments with the other chemical. In the experiments with the other chemical, the permeability increased more and the amounts of dissolved iron were larger. According to the results from the experiments, the method of application of the washing solutions had an impact on the washing results.

Improving Evaluation and Development Capability in Verification and Validation

Validation and verification operations encounter various challenges in product development process. Requirements for increasing the development cycle pace set new requests for component development process. Verification and validation usually represent the largest activities, up to 40 50 % of R&D resources utilized. This research studies validation and verification as part of case company's component development process. The target is to define framework that can be used in improvement of the validation and verification capability evaluation and development in display module development projects. Validation and verification definition and background is studied in this research. Additionally, theories such as project management, system, organisational learning and causality is studied. Framework and key findings of this research are presented. Feedback system according of the framework is defined and implemented to the case company. This research is divided to the theory and empirical parts. Theory part is conducted in literature review. Empirical part is done in case study. Constructive methode and design research methode are used in this research A framework for capability evaluation and development was defined and developed as result of this research. Key findings of this study were that double loop learning approach with validation and verification V+ model enables defining a feedback reporting solution. Additional results, some minor changes in validation and verification process were proposed. There are a few concerns expressed on the results on validity and reliability of this study. The most important one was the selected research method and the selected model itself. The final state can be normative, the researcher may set study results before the actual study and in the initial state, the researcher may describe expectations for the study. Finally reliability of this study, and validity of this work are studied.

APROS model validation in case of fast transients in a boiling water reactor

This Master´s thesis investigates the performance of the Olkiluoto 1 and 2 APROS model in case of fast transients. The thesis includes a general description of the Olkiluoto 1 and 2 nuclear power plants and of the most important safety systems. The theoretical background of the APROS code as well as the scope and the content of the Olkiluoto 1 and 2 APROS model are also described. The event sequences of the anticipated operation transients considered in the thesis are presented in detail as they will form the basis for the analysis of the APROS calculation results. The calculated fast operational transient situations comprise loss-of-load cases and two cases related to a inadvertent closure of one main steam isolation valve. As part of the thesis work, the inaccurate initial data values found in the original 1-D reactor core model were corrected. The input data needed for the creation of a more accurate 3-D core model were defined. The analysis of the APROS calculation results showed that while the main results were in good accordance with the measured plant data, also differences were detected. These differences were found to be caused by deficiencies and uncertainties related to the calculation model. According to the results the reactor core and the feedwater systems cause most of the differences between the calculated and measured values. Based on these findings, it will be possible to develop the APROS model further to make it a reliable and accurate tool for the analysis of the operational transients and possible plant modifications.

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.

A Farewell to Flat Biology. Three-dimensional Cell Culture Models in Cancer Drug Target Identification and Validation

Cells of epithelial origin, e.g. from breast and prostate cancers, effectively differentiate into complex multicellular structures when cultured in three-dimensions (3D) instead of conventional two-dimensional (2D) adherent surfaces. The spectrum of different organotypic morphologies is highly dependent on the culture environment that can be either non-adherent or scaffold-based. When embedded in physiological extracellular matrices (ECMs), such as laminin-rich basement membrane extracts, normal epithelial cells differentiate into acinar spheroids reminiscent of glandular ductal structures. Transformed cancer cells, in contrast, typically fail to undergo acinar morphogenic patterns, forming poorly differentiated or invasive multicellular structures. The 3D cancer spheroids are widely accepted to better recapitulate various tumorigenic processes and drug responses. So far, however, 3D models have been employed predominantly in the Academia, whereas the pharmaceutical industry has yet to adopt a more widely and routine use. This is mainly due to poor characterisation of cell models, lack of standardised workflows and high throughput cell culture platforms, and the availability of proper readout and quantification tools. In this thesis, a complete workflow has been established entailing well-characterised 3D cell culture models for prostate cancer, a standardised 3D cell culture routine based on high-throughput-ready platform, automated image acquisition with concomitant morphometric image analysis, and data visualisation, in order to enable large-scale high-content screens. Our integrated suite of software and statistical analysis tools were optimised and validated using a comprehensive panel of prostate cancer cell lines and 3D models. The tools quantify multiple key cancer-relevant morphological features, ranging from cancer cell invasion through multicellular differentiation to growth, and detect dynamic changes both in morphology and function, such as cell death and apoptosis, in response to experimental perturbations including RNA interference and small molecule inhibitors. Our panel of cell lines included many non-transformed and most currently available classic prostate cancer cell lines, which were characterised for their morphogenetic properties in 3D laminin-rich ECM. The phenotypes and gene expression profiles were evaluated concerning their relevance for pre-clinical drug discovery, disease modelling and basic research. In addition, a spontaneous model for invasive transformation was discovered, displaying a highdegree of epithelial plasticity. This plasticity is mediated by an abundant bioactive serum lipid, lysophosphatidic acid (LPA), and its receptor LPAR1. The invasive transformation was caused by abrupt cytoskeletal rearrangement through impaired G protein alpha 12/13 and RhoA/ROCK, and mediated by upregulated adenylyl cyclase/cyclic AMP (cAMP)/protein kinase A, and Rac/ PAK pathways. The spontaneous invasion model tangibly exemplifies the biological relevance of organotypic cell culture models. Overall, this thesis work underlines the power of novel morphometric screening tools in drug discovery.