Oops! Another medication error : a literature review of contributing factors and methods to prevent medication errors

The purpose of this bachelor's thesis was to chart scientific research articles to present contributing factors to medication errors done by nurses in a hospital setting, and introduce methods to prevent medication errors. Additionally, international and Finnish research was combined and findings were reflected in relation to the Finnish health care system. Literature review was conducted out of 23 scientific articles. Data was searched systematically from CINAHL, MEDIC and MEDLINE databases, and also manually. Literature was analysed and the findings combined using inductive content analysis. Findings revealed that both organisational and individual factors contributed to medication errors. High workload, communication breakdowns, unsuitable working environment, distractions and interruptions, and similar medication products were identified as organisational factors. Individual factors included nurses' inability to follow protocol, inadequate knowledge of medications and personal qualities of the nurse. Developing and improving the physical environment, error reporting, and medication management protocols were emphasised as methods to prevent medication errors. Investing to the staff's competence and well-being was also identified as a prevention method. The number of Finnish articles was small, and therefore the applicability of the findings to Finland is difficult to assess. However, the findings seem to fit to the Finnish health care system relatively well. Further research is needed to identify those factors that contribute to medication errors in Finland. This is a necessity for the development of methods to prevent medication errors that fit in to the Finnish health care system.

Establishing intercompany relationships: Motives and methods for successful collaborative engagement

This study explores the early phases of intercompany relationship building, which is a very important topic for purchasing and business development practitioners as well as for companies' upper management. There is a lot ofevidence that a proper engagement with markets increases a company's potential for achieving business success. Taking full advantage of the market possibilities requires, however, a holistic view of managing related decision-making chain. Most literature as well as the business processes of companies are lacking this holism. Typically they observe the process from the perspective of individual stages and thus lead to discontinuity and sub-optimization. This study contains a comprehensive introduction to and evaluation of literature related to various steps of the decision-making process. It is studied from a holistic perspective ofdetermining a company's vertical integration position within its demand/ supplynetwork context; translating the vertical integration objectives to feasible strategies and objectives; and operationalizing the decisions made through engagement with collaborative intercompany relationships. The empirical part of the research has been conducted in two sections. First the phenomenon of intercompany engagement is studied using two complementary case studies. Secondly a survey hasbeen conducted among the purchasing and business development managers of several electronics manufacturing companies, to analyze the processes, decision-makingcriteria and success factors of engagement for collaboration. The aim has been to identify the reasons why companies and their management act the way they do. As a combination of theoretical and empirical research an analysis has been produced of what would be an ideal way of engaging with markets. Based on the respective findings the study concludes by proposing a holistic framework for successful engagement. The evidence presented throughout the study demonstrates clear gaps, discontinuities and limitations in both current research and in practical purchasing decision-making chains. The most significant discontinuity is the identified disconnection between the supplier selection process and related criteria and the relationship success factors.

The synchronization of personal information between mobile devices and online services by using SyncML

Monet henkilökohtaiset mobiililaitteet tarjoavat mahdollisuuden tallentaa henkilötietoja ja mahdollisuuden lyhyen kantaman radiotekniikoiden hyödyntämiseen. Vastaavasti henkilötietoja käyttävien tai vaativien verkkopalveluiden määrä on kasvussa. Mobiililaitteisiin tallennetut henkilötiedot tarjoavat potentiaalisen keinon välttää samojen henkilötietojen toistuva käsinsyöttö erilaisiin verkkopalveluihin ja keskitettyyn ajantasallapitoon. Tässä työssä käydään läpi ratkaisumalli henkilökohtaisen mobiililaitteen ja verkkopalveluiden välillä tapahtuvaan henkilötietojen siirtoon ja synkronointiin. Malli pohjautuu selainlaajennukseen, joka voi pyytää sekä selaimessa auki olevalta verkkopalvelun sivulta että mobiililta päätelaitteelta senhetkiset henkilötiedot ja synkronoida ne. Jo olemassaolevia henkilötietojen hallintaa helpottavia ratkaisuja käydään läpi arvioiden käyttökelpoisuutta tämänkaltaisiin tarpeisiin. Ratkaisumallin kannalta olennaiset tekniikat ja standardit, erityisesti Bluetooth ja SyncML, esitellään. Ratkaisumallin arkkitehtuuri käydään korkealla tasolla läpi ja esitellään toteutuksen yksityiskohtia. Tuloksena on periaatteeltaan kelvollinen henkilökohtaisten tietojen synkronointijärjestelmä, jonka toteutusta nykyisten mobiilien päätelaitteiden toiminnallisuus jossain määrin hankaloittaa.

Probiotic lactobacilli and bifidobacteria in the mouth – in vitro studies on saliva-mediated functions and acid production

Probiotic lactobacilli and bifidobacteria in the mouth – in vitro studies on saliva-mediated functions and acid production Probiotics are viable bacteria which, when used in adequate amounts, are beneficial to the health of the host. Although most often related to intestinal health, probiotic bacteria can be found also in the mouth after consumption of products that contain them. This study aimed at evaluating the oral effects of probiotic bacteria already in commercial use. In a series of in vitro studies, the oral colonisation potential of different probiotic bacteria, their acid production and potential saliva-mediated effects on oral microbial ecology were investigated. The latter included effects on the salivary pellicle, the adhesion of other bacteria, and the activation of the peroxidase system. Streptococcus mutans, Streptococcus gordonii, Aggregatibacter actinomycetemcomitans and Helicobacter pylori were used as bacterial indicators of the studied phenomena. There were significant differences between the probiotic strains in their colonisation potential. They all were acidogenic, although using different sugars and sugar alcohols. However, their acid production could be inhibited by the peroxidase system. Based on the results, it can be suggested that probiotic bacteria might influence the oral microbiota by different, partly species or strain-specific means. These include the inhibition of bacterial adhesion, modification of the enamel pellicle, antimicrobial activity, and activation of the peroxidase system. To conclude, probiotic strains differed from each other in their colonisation potential and other oral effects as evaluated in vitro. Both positive and potentially harmful effects were observed, but the significance of the perceived results needs to be further evaluated in vivo.

Strategic Development of Electricity Distribution Networks – Concept and Methods

Strategic development of distribution networks plays a key role in the asset management in electricity distribution companies. Owing to the capital-intensive nature of the field and longspan operations of companies, the significance of a strategy is emphasised. A well-devised strategy combines awareness of challenges posed by the operating environment and the future targets of the distribution company. Economic regulation, ageing infrastructure, scarcity of resources and tightening supply requirements with challenges created by the climate change put a pressure on the strategy work. On the other hand, technology development related to network automation and underground cabling assists in answering these challenges. This dissertation aims at developing process knowledge and establishing a methodological framework by which key issues related to network development can be addressed. Moreover, the work develops tools by which the effects of changes in the operating environment on the distribution business can be analysed in the strategy work. To this end, the work discusses certain characteristics of the distribution business and describes the strategy process at a principle level. Further, the work defines the subtasks in the strategy process and presents the key elements in the strategy work and long-term network planning. The work delineates the factors having either a direct or indirect effect on strategic planning and development needs in the networks; in particular, outage costs constitute an important part of the economic regulation of the distribution business, reliability being thus a key driver in network planning. The dissertation describes the methodology and tools applied to cost and reliability analyses in the strategy work. The work focuses on determination of the techno-economic feasibility of different network development technologies; these feasibility surveys are linked to the economic regulation model of the distribution business, in particular from the viewpoint of reliability of electricity supply and allowed return. The work introduces the asset management system developed for research purposes and to support the strategy work, the calculation elements of the system and initial data used in the network analysis. The key elements of this asset management system are utilised in the dissertation. Finally, the study addresses the stages of strategic decision-making and compilation of investment strategies. Further, the work illustrates implementation of strategic planning in an actual distribution company environment.

Demand forecasting process design and methods in medium sized enterprise

The purpose of this thesis was to study the design of demand forecasting processes and management of demand. In literature review were different processes found and forecasting methods and techniques interviewed. Also role of bullwhip effect in supply chain was identified and how to manage it with information sharing operations. In the empirical part of study is at first described current situation and challenges in case company. After that will new way to handle demand introduced with target budget creation and how information sharing with 5 products and a few customers would bring benefits to company. Also the new S&OP process created within this study and organization for it.

A SOA-based Framework for Multi-Devices and Multi-Platform User Interfaces

This thesis reports investigations on applying the Service Oriented Architecture (SOA) approach in the engineering of multi-platform and multi-devices user interfaces. This study has three goals: (1) analyze the present frameworks for developing multi-platform and multi-devices applications, (2) extend the principles of SOA for implementing a multi-platform and multi-devices architectural framework (SOA-MDUI), (3) applying and validating the proposed framework in the context of a specific application. One of the problems addressed in this ongoing research is the large amount of combinations for possible implementations of applications on different types of devices. Usually it is necessary to take into account the operating system (OS), user interface (UI) including the appearance, programming language (PL) and architectural style (AS). Our proposed approach extended the principles of SOA using patterns-oriented design and model-driven engineering approaches. Synthesizing the present work done in these domains, this research built and tested an engineering framework linking Model-driven Architecture (MDA) and SOA approaches to developing of UI. This study advances general understanding of engineering, deploying and managing multi-platform and multi-devices user interfaces as a service.

Data analysis tools and methods for DNA microarray and high-throughput sequencing data

The recent rapid development of biotechnological approaches has enabled the production of large whole genome level biological data sets. In order to handle thesedata sets, reliable and efficient automated tools and methods for data processingand result interpretation are required. Bioinformatics, as the field of studying andprocessing biological data, tries to answer this need by combining methods and approaches across computer science, statistics, mathematics and engineering to studyand process biological data. The need is also increasing for tools that can be used by the biological researchers themselves who may not have a strong statistical or computational background, which requires creating tools and pipelines with intuitive user interfaces, robust analysis workflows and strong emphasis on result reportingand visualization. Within this thesis, several data analysis tools and methods have been developed for analyzing high-throughput biological data sets. These approaches, coveringseveral aspects of high-throughput data analysis, are specifically aimed for gene expression and genotyping data although in principle they are suitable for analyzing other data types as well. Coherent handling of the data across the various data analysis steps is highly important in order to ensure robust and reliable results. Thus,robust data analysis workflows are also described, putting the developed tools andmethods into a wider context. The choice of the correct analysis method may also depend on the properties of the specific data setandthereforeguidelinesforchoosing an optimal method are given. The data analysis tools, methods and workflows developed within this thesis have been applied to several research studies, of which two representative examplesare included in the thesis. The first study focuses on spermatogenesis in murinetestis and the second one examines cell lineage specification in mouse embryonicstem cells.

Control hardware and Condition Monitoring System for Intersector Weld/Cut Robot

Työ sisältää ohjaislaitteiston vertailun ja valinnan rinnakkaisrakenteista robottia varten sekä kunnonvalvontajärjestelmän periaatteiden laadinnan kyseistä robottia varten. Ohjauslaitteisto sisältää teollisuustietokoneen sekä kenttäväylän. Sekä tietokoneesta että väylästä on teoriaosuus ja yksityiskohtaisempi valintaosuus. Teoriaosuudessa selitetään tarkemmin laitteiden toimintaperiaatteista. Valintaosuudessa kerrotaanmiksi jokin tietty laite on valittu käytettäväksi robotin ohjauksessa. Kunnonvalvontateoria ja rinnakkaisrakenteisen robotin kunnonvalvonnan keinot ovat työn toinen osa. Teoriaosa sisältää yleisluonteisen selvityksen vikaantumisesta ja valvonnasta. Erikoisrobotin kunnonvalvonnan keinot esitetään työssä tietyssä järjestyksessä. Ensin esitetään mahdolliset vikatilanteet. Toisessa kohdassa havainnollistetaan vikojen havaitseminen.

Hydrodynamics and Heat Transfer in an Airlift Reactor

Työn teoriaosassa esitetään kirjallisuudessa esiintyviä teoreettisia ja kokeellisia yhtälöitä nesteen nopeuden, kaasun tilavuusosuuden, painehäviön ja lämmönsiirron laskemiseksi. Lisäksi käsitellään airlift-reaktoreiden toimintaa, rakennetta ja teollisia sovelluksia, sekä sekoitusta ja geometrian vaikutusta airlift-reaktoreiden hydrodynaamisiin ominaisuuksiin. Kokeellisessa osassa kuvataan käytetty koelaitteisto ja mittausmenetelmät sekä esitetään saadut koetulokset. Koelaitteisto on viidellä nousuputkella varustettu ulkoisen kierron airlift-reaktori. Kokeellisessa osassa pyritään ratkaisemaan tällaisessa reaktorissa mahdollisesti esiintyviä ongelmia, kuten "slug flown" muodostuminen nousuputkissa sekä fluidien epätasainen jakautuminen nousuputkiin. Lisäksi tutkitaan erilaisten muuttujien, kuten kaasun tilavuusvirran, nesteen viskositeetin, suutinkoon ja nesteen jakoputken rakenteen, vaikutusta kaasun tilavuusosuuteen ja nesteen nopeuteen nousuputkissa. Nesteen nopeudet mitataan merkkiainemenetelmällä ja kaasun tilavuusosuudet manometrimenetelmällä. Lämmönsiirtoa tutkitaan mittaamalla lämpötilaeroja nousuputkissa NiCr-Ni –termoelementeillä. Mittaustulosten perusteella muokataan korrelaatiot kaasun tilavuusosuudelle ja nesteen tyhjäputkinopeudelle. Korrelaatioista lasketut tulokset sopivat kohtuullisen hyvin yhteen mitattujen tulosten kanssa. "Slug flown" ei todettu muodostuvan ongelmaksi 2.5 mPa s pienemmillä viskositeetin arvoilla 2 metriä pitkissä ja 19 mm halkaisijaltaan olevissa putkissa. Lisäksi todettiin, että kaasu- ja nestefaasien jakautumisongelmat voidaan ratkaista rakenteellisesti.

Gamma spectrometry and gamma and X-ray tomography of nuclear fuel

The purpose of gamma spectrometry and gamma and X-ray tomography of nuclear fuel is to determine both radionuclide concentration and integrity and deformation of nuclear fuel. The aims of this thesis have been to find out the basics of gamma spectrometry and tomography of nuclear fuel, to find out the operational mechanisms of gamma spectrometry and tomography equipment of nuclear fuel, and to identify problems that relate to these measurement techniques. In gamma spectrometry of nuclear fuel the gamma-ray flux emitted from unstable isotopes is measured using high-resolution gamma-ray spectroscopy. The production of unstable isotopes correlates with various physical fuel parameters. In gamma emission tomography the gamma-ray spectrum of irradiated nuclear fuel is recorded for several projections. In X-ray transmission tomography of nuclear fuel a radiation source emits a beam and the intensity, attenuated by the nuclear fuel, is registered by the detectors placed opposite. When gamma emission or X-ray transmission measurements are combined with tomographic image reconstruction methods, it is possible to create sectional images of the interior of nuclear fuel. MODHERATO is a computer code that simulates the operation of radioscopic or tomographic devices and it is used to predict and optimise the performance of imaging systems. Related to the X-ray tomography, MODHERATO simulations have been performed by the author. Gamma spectrometry and gamma and X-ray tomography are promising non-destructive examination methods for understanding fuel behaviour under normal, transient and accident conditions.

Competence Development and Capacity Building of Sawmill Enterprises in Kenya – A Human Resources Development Approach

The Kenyan forestry and sawmilling industry have been subject to a changing environment since 1999 when the industrial forest plantations were closed down. This has lowered raw material supply and it has affected and reduced the sawmill operations and the viability of the sawmill enterprises. The capacity of the 276 registered sawmills is not sufficient to fulfill sawn timber demand in Kenya. This is because of the technological degradation and lack of a qualified labor force, which were caused because of non-existent sawmilling education and further training in Kenya. Lack of competent sawmill workers has led to low raw material recovery, under utilization of resources and loss of employment. The objective of the work was to suggest models, methods and approaches for the competence and capacity development of the Kenyan sawmilling industry, sawmills and their workers. A nationwide field survey, interviews, questionnaire and literature review was used for data collection to find out the sawmills’ competence development areas and to suggest models and methods for their capacity building. The sampling frame included 22 sawmills that represented 72,5% of all the registered sawmills in Kenya. The results confirmed that the sawmills’ technological level was backwards, productivity low, raw material recovery unacceptable and workers’ professional education low. The future challenges will be how to establish the sawmills’ capacity building and workers’ competence development. Sawmilling industry development requires various actions through new development models and approaches. Activities should be started for technological development and workers’ competence development. This requires re-starting of vocational training in sawmilling and the establishment of more effective co-operation between the sawmills and their stakeholder groups. In competence development the Enterprise Competence Management Model of Nurminen (2007) can be used, whereas the best training model and approach would be a practically oriented learning at work model in which the short courses, technical assistance and extension services would be the key functions.

Methods and Models for Accelerating Dynamic Simulation of Fluid Power Circuits

The objective of this dissertation is to improve the dynamic simulation of fluid power circuits. A fluid power circuit is a typical way to implement power transmission in mobile working machines, e.g. cranes, excavators etc. Dynamic simulation is an essential tool in developing controllability and energy-efficient solutions for mobile machines. Efficient dynamic simulation is the basic requirement for the real-time simulation. In the real-time simulation of fluid power circuits there exist numerical problems due to the software and methods used for modelling and integration. A simulation model of a fluid power circuit is typically created using differential and algebraic equations. Efficient numerical methods are required since differential equations must be solved in real time. Unfortunately, simulation software packages offer only a limited selection of numerical solvers. Numerical problems cause noise to the results, which in many cases leads the simulation run to fail. Mathematically the fluid power circuit models are stiff systems of ordinary differential equations. Numerical solution of the stiff systems can be improved by two alternative approaches. The first is to develop numerical solvers suitable for solving stiff systems. The second is to decrease the model stiffness itself by introducing models and algorithms that either decrease the highest eigenvalues or neglect them by introducing steady-state solutions of the stiff parts of the models. The thesis proposes novel methods using the latter approach. The study aims to develop practical methods usable in dynamic simulation of fluid power circuits using explicit fixed-step integration algorithms. In this thesis, twomechanisms whichmake the systemstiff are studied. These are the pressure drop approaching zero in the turbulent orifice model and the volume approaching zero in the equation of pressure build-up. These are the critical areas to which alternative methods for modelling and numerical simulation are proposed. Generally, in hydraulic power transmission systems the orifice flow is clearly in the turbulent area. The flow becomes laminar as the pressure drop over the orifice approaches zero only in rare situations. These are e.g. when a valve is closed, or an actuator is driven against an end stopper, or external force makes actuator to switch its direction during operation. This means that in terms of accuracy, the description of laminar flow is not necessary. But, unfortunately, when a purely turbulent description of the orifice is used, numerical problems occur when the pressure drop comes close to zero since the first derivative of flow with respect to the pressure drop approaches infinity when the pressure drop approaches zero. Furthermore, the second derivative becomes discontinuous, which causes numerical noise and an infinitely small integration step when a variable step integrator is used. A numerically efficient model for the orifice flow is proposed using a cubic spline function to describe the flow in the laminar and transition areas. Parameters for the cubic spline function are selected such that its first derivative is equal to the first derivative of the pure turbulent orifice flow model in the boundary condition. In the dynamic simulation of fluid power circuits, a tradeoff exists between accuracy and calculation speed. This investigation is made for the two-regime flow orifice model. Especially inside of many types of valves, as well as between them, there exist very small volumes. The integration of pressures in small fluid volumes causes numerical problems in fluid power circuit simulation. Particularly in realtime simulation, these numerical problems are a great weakness. The system stiffness approaches infinity as the fluid volume approaches zero. If fixed step explicit algorithms for solving ordinary differential equations (ODE) are used, the system stability would easily be lost when integrating pressures in small volumes. To solve the problem caused by small fluid volumes, a pseudo-dynamic solver is proposed. Instead of integration of the pressure in a small volume, the pressure is solved as a steady-state pressure created in a separate cascade loop by numerical integration. The hydraulic capacitance V/Be of the parts of the circuit whose pressures are solved by the pseudo-dynamic method should be orders of magnitude smaller than that of those partswhose pressures are integrated. The key advantage of this novel method is that the numerical problems caused by the small volumes are completely avoided. Also, the method is freely applicable regardless of the integration routine applied. The superiority of both above-mentioned methods is that they are suited for use together with the semi-empirical modelling method which necessarily does not require any geometrical data of the valves and actuators to be modelled. In this modelling method, most of the needed component information can be taken from the manufacturer’s nominal graphs. This thesis introduces the methods and shows several numerical examples to demonstrate how the proposed methods improve the dynamic simulation of various hydraulic circuits.

St. Petersburg Court Chant and the Tradition of Eastern Slavic Church Singing

The present study examines the repertory of liturgical chant known as St. Petersburg Court Chant which emerged within the Imperial Court of St. Petersburg, Russia, and appeared in print in a number of revisions during the course of the 19th century, eventually to spread throughout the Russian Empire and even abroad. The study seeks answers to questions on the essence and composition of Court Chant, its history and liturgical background, and most importantly, its musical relationship to other repertories of Eastern Slavic chant. The research questions emerge from previous literary accounts of Court Chant (summarized in the Introduction), which have tended to be inaccurate and generally not based on critical research. The study is divided into eight main chapters. Chapter 1 provides a survey of the history of Eastern Slavic chant and the Imperial Court Chapel of St. Petersburg until 1917, with special emphasis on the history of singing traditional chant in polyphony, the status of the Court Chapel as a government authority, and its endeavours in publishing church music. Chapter 2 deals with the liturgical background of Eastern chant, the chant genres, and main repertories of Eastern Slavic chant. Chapter 3 concentrates on chant sources: it introduces the musical notations utilised, after which a typology of chant books is presented. The discussion continues with a survey of the sources of Court Chant and their content, the specimens selected for closer analysis, the comparative materials from other repertories, and ends with a commentary on some chant sources that have been excluded. The comparative sources include a specimen from around the beginning of the 12th century, a few manuscripts from the 17th century, and printed and manuscript chant books from the early 18th to early 20th century, covering the geographical area that delimits to the western Ukraine, Astrakhan, Nizhny Novgorod, and the Solovetsky Monastery. Chapter 4 presents the approach and methods used in the subsequent analytical comparisons. After a survey of the pitch organization of Eastern Slavic chant, the customary harmonization strategy of traditional chant polyphony is examined, according to which a method for meaningful analysis of the harmony is proposed. The method is based on the observation that the harmonic framework of chant polyphony derives from the standard pitch collection of monodic chant known as the Church Gamut, specific pitches of which form eight harmonic regions that behave like the usual tonalities of major and harmonic minor. Because of the considerable quantity of comparative chant forms, computer-assisted statistical methods are applied to the analysis of chant melodies. The primary chant forms and their respective comparative forms have been pre-processed into reduced chant prototypes and divided into redactions. The analyses are carried out by measuring the formal dissimilarities of the primary chant forms of the Court Chant repertory against each comparative form, and also by measuring the reciprocal dissimilarities of all chant versions in a redaction, the results of which are subjected to agglomerative hierarchical clustering in order to find out how the chant forms relate to each other. The dissimilarities are determined by applying a metric dissimilarity function that is based on the Levenshtein Distance. Chapter 5 provides the melodic and harmonic analyses of generic chants (chants used for multiple texts of different lengths), i.e., chants for stichera samoglasny and troparia, Chapter 6 of pseudo-generic chants (chants that are used for multiple texts but with certain restrictions), i.e., chants for heirmoi, prokeimena, and three other hymns, and Chapter 7 of non-generic chants, covering nine chants that in the Court repertory are not shared by multiple texts. The results are summarized and evaluated in Chapter 8. Accordingly, it can be established that, contrary to previous conceptions, melodically, Court Chant is in effect a full part of the wider Eastern Slavic chant tradition. Even if it is somewhat detached from the chant versions of the Synodal square-note chant books and the local tradition of Moscow, it is particularly close to chant forms of East Ukraine and some vernacular repertories from Russia. Respectively, the harmonization strategies of Court Chant do not show significant individuality in comparison with those of the available polyphonic comparative sources, the main difference being the part-writing, which generally conforms to western common practice standard, whereas the deviations from this tend to be more significant in other analysed repertories of polyphonic chant. Thus, insofar as the subsequent prevalence of Court Chant is not based on its forceful dissemination by authorities (as suggested in previous literature but for which little tangible evidence could be found in Chapter 1), in the present author’s interpretation, Court Chant attained its dominance principally because musically it was considered sufficiently traditional, and as a chant body supported by the government, was conveniently available in print in serviceable harmonizations.