An Infant with Food Allergy and Eczema in the Family – The Mental and Economic Burden of Caring

Allergic diseases including food allergy and eczema in an infant in combination with the everyday activities of caring for a family will pose challenges to parents. Only fragments of these challenges are revealed to health care professionals. Families have varying mental, social and economic resources to help them care for an allergic infant, and all such resources are important in determining how families succeed in meeting these challenges and the quality of the infant’s care. This study evaluated the whole burden to the family caused by an infant's allergic disease during the first 24 months of life. As the primary caregiver during this period is usually the mother, her perspective was considered important. Ecocultural theory, which considers families as capable of modifying the positive and negative forces facing them, was taken as the frame of reference. Data were collected as part of an ongoing prospective mother-infant study, and the methods included severity scoring of atopic dermatitis, dietary records, health-related quality of life measurements and assessments of the use of health care services and medications for treating the infant’s eczema, food allergy and asthma. Interviews with mothers were analysed by deductive content analysis on the basis of ecocultural theory and the family empowerment model. The theme “Living an ordinary family life” guided the organization of family activities essential for treating the infant's food allergy and eczema. These activities were sources of both strain and support for the mothers, the allergy-related supporting factors being the mother’s own knowledge of the allergy, hopes for an improvement in the infant’s condition, social support and work. An infant’s food allergy at the age of one year caused considerable strain for the mother in cases where the introduction of new foods into the child’s diet was delayed. This delay was still causing the mother additional strain when the child was 24 months of age. The infants waking at night at the ages of 12 and 24 months because of itching related to eczema caused strain for the mothers. The infants’ health-related quality of life was impaired at ages of 6 and 12 months compared with healthy infants. The principal reasons for impairments were itching, scratching and sleep disturbances at 6 and 12 months and treatment difficulties at 6 months. Problems with getting to sleep were reported at all stages irrespective of eczema and were also present in healthy infants. The economic impact of the treatment of allergic diseases on families during the first 24 months was 131 EUR (2006 value) in cases of eczema and 525 EUR in cases of food allergy. From the societal perspective, the costs of food allergy were a median of 3183 EUR (range 628–11 560 EUR) and of eczema a median of 275 EUR (range 94–1306 EUR). These large variations in costs in food allergy and eczema indicate that disease varies greatly . In conclusion, food allergy and eczema cause extra activities and costs to families which arrange these disease-related activities in such a way that they support the leading family theme “Living an ordinary family life”. Health care professionals should consider this thematic character of family life and disease-related activities in order to ensure that new treatments are sustainable, meaningful and tailored to daily activities. In addition, those mothers who are experiencing difficulties with food allergic infants or infants with eczema should be recognized early and provided with individual encouragement and support from health clinics. In the light of the present results, early detection of symptoms and effective parental guidance can contribute to the well-being and health-related quality of life of the child and family.

Economic Burden of Psoriasis

Psoriasis may cause a substantial economic burden to patients, health service providers, third parties, and the society as a whole. However, all of these costs may not be adequately considered when assessing the treatment costs for psoriasis. Psoriasis may negatively affect work productivity as psoriasis has a relatively high incidence in working age people that lead to possible costs because of lost productivity. The aims of this thesis were to estimate the economic burden of psoriasis particularly from patients’ and health service providers’ perspectives and to estimate the background factors (e.g., severity of psoriasis) that may have led to high costs. Another aim was to estimate the total medication costs and to estimate psoriasis’ proportion of health-related productivity losses. The patient sample was based on patients with psoriasis who visited the Department of Dermatology in Turku University Hospital during a one-year study period. These patients were sent a questionnaire. From the patients who gave consent, medication information, clinical information, and number of visits to Turku University Hospital were collected. This data was linked to the information from the questionnaire. Overall psoriasis was estimated to cause a substantial economic burden for the patient, health service provider, health insurance system, employer, and the society as a whole. The direct costs represented only a small proportion of the overall financial burden of psoriasis, whereas indirect costs were significant. The estimated annual costs for patients and employers were almost twice the costs to health service providers or the Social Insurance Institution of Finland. In conclusion, the cost contribution of patients and employers should be considered when assessing the costs of different treatments, in addition to commonly studied direct costs of medications and costs to health service providers. Methods used to assess these costs should be well justified and be described clearly to allow comparisons between studies and to evaluate the quality of the results.

Effects of three harvesting work methods on Harwarder productivity in final felling

Abstract

The attractiveness of the work is affected when production of handcrafted log houses moves indoors

Abstract

Using tools to help cost estimating and pricing: examination of costing model's and cost breakdown's workability and their capability to cooperative work

Tämä diplomityö käsittelee työkaluja, jotka on suunniteltu kustannusten ennakointiin ja hinnan asetantaan. Aluksi on käyty läpi perinteisen ja toimintoperusteisen kustannuslaskennan perusteita. Näiden menetelmien välisiä eroja on tarkasteltu ja toimintoperusteisen kustannuslaskennan paremmin sopivuus nykypäivän yrityksille on perusteltu. Toisena käsitellään hinnoittelu. Hinnan merkitys, hinnoittelumenetelmät ja päätös lopullisesta hinnasta on käyty läpi. Hinnoittelun jälkeen esitellään kustannusjärjestelmät ja kustannusten arviointi. Nämä asiat todistavat, että tarkat kustannusarviot ovat elintärkeitä yritykselle. Tuotteen kustannusarviointi, hinnan asetanta ja tarjoaminen ovat erittäin merkityksellisiä asioita ottaen huomioon koko projektin elinkaaren ja tulevat tuotot. Nykyään on yleistä käyttää työkaluja kustannusarvioinnissa ja joskus myös hinnoittelussa. Työkalujen luotettavuus on tiedettävä, ennenkuin työkalut otetaan käyttöön. Myös työkalujen käyttäjät täytyy perehdyttää hyvin. Muuten yritys todennäköisesti kohtaa odottamattomia ja epämiellyttäviä yllätyksiä.

Matemaattiset opetusympäristöt ja matemaattisen käyttöliittymän käytettävyys

Tämän diplomityön tarkoituksena on kuvata Lappeenrannan teknillisessä yliopistossa kehitetyn luentojen tueksi tarkoitetun Matematiikan virtuaalimateriaalin hallintaympäristön kehityskaari. Järjestelmä luotiin parantamaanopetuksen laatua siten, että sen avulla opiskelijat saavat helposti käyttöönsä suomenkielistä, laadukkaalla kirjoitusjäljellä olevaa opiskelumateriaalia 24 tuntia vuorokaudessa. Lisäksi järjestelmän tavoitteena oli helpottaa opettajien työtaakkaa siten, että he pystyvät luomaan viikoittaiset harjoitustehtäväpaketit sekä tentit suoraan tietokannasta. Järjestelmän kehitys alkoi vuonna 2001, jonka jälkeen sitä on jatkuvasti muokattu opettajien ja opiskelijoiden avustuksella yhäkäyttäjäystävällisempään suuntaan. Testausmenetelminä on käytetty asiantuntijatestausta, lomakkeita ja varsinaista loppukäyttäjätestausta. Kehityksen tuloksenaon saatu järjestelmä, joka voidaan ottaa käyttöön kaikessa matematiikan perusopetuksessa.

Design and implementation of FPGA-based LQ control of active magnetic bearings

The need for high performance, high precision, and energy saving in rotating machinery demands an alternative solution to traditional bearings. Because of the contactless operation principle, the rotating machines employing active magnetic bearings (AMBs) provide many advantages over the traditional ones. The advantages such as contamination-free operation, low maintenance costs, high rotational speeds, low parasitic losses, programmable stiffness and damping, and vibration insulation come at expense of high cost, and complex technical solution. All these properties make the use of AMBs appropriate primarily for specific and highly demanding applications. High performance and high precision control requires model-based control methods and accurate models of the flexible rotor. In turn, complex models lead to high-order controllers and feature considerable computational burden. Fortunately, in the last few years the advancements in signal processing devices provide new perspective on the real-time control of AMBs. The design and the real-time digital implementation of the high-order LQ controllers, which focus on fast execution times, are the subjects of this work. In particular, the control design and implementation in the field programmable gate array (FPGA) circuits are investigated. The optimal design is guided by the physical constraints of the system for selecting the optimal weighting matrices. The plant model is complemented by augmenting appropriate disturbance models. The compensation of the force-field nonlinearities is proposed for decreasing the uncertainty of the actuator. A disturbance-observer-based unbalance compensation for canceling the magnetic force vibrations or vibrations in the measured positions is presented. The theoretical studies are verified by the practical experiments utilizing a custom-built laboratory test rig. The test rig uses a prototyping control platform developed in the scope of this work. To sum up, the work makes a step in the direction of an embedded single-chip FPGA-based controller of AMBs.

Ethnic sensitive substance abuse work : services for non-Finnish speaking clients in substance abuse treatment units in Finland today

The purpose of this study was to examine the current situation in substance abuse treatment units in Finland in taking non-Finnish speaking clients into consideration. The initiative for this research came from the Development of Alcohol and Drugs Intervention group at Stakes (National Research and Development Centre for Welfare and Health). Their aim was to gather information about the functioning and relevance of the quality assessment forms based on the quality recommendations for substance abuse work, filled in by substance abuse treatment units. The ethnic issue was chosen as the main approach in the study. The aim of this research was to answer the following questions: what is the readiness and competence in substance abuse treatment units in Finland to receive and encounter non-Finnish speaking clients, how is the quality of these services assessed and/or developed in the units, and what has been the role and functioning of the quality recommendations and quality assessment forms in working with non-Finnish speaking clients. The research methods used in the study were both quantitative and qualitative. The information concerning language services provided in the units was gathered from the quality assessment forms and basic information forms found in the database maintained by Stakes. The total amount of units found in the database was 267. In addition to that, semi-structured theme-interviews were carried out in four substance abuse treatment units in order to get a more deep understanding of how the services function in practice. The few number of non-Finnish speaking clients in the units may explain to a certain degree the results of the research. The results however showed that there is still space for improving the services. In the light of quality recommendations, the degree of language options provided in substance abuse treatment units in Finland today is low. Also the quantity of interpreter services provided in the units is scarce. There could also be unified guidelines specially tailored for substance abuse treatment units on how to work with ethnic minorities, as the knowledge is currently adopted from several different instances. The quality recommendations as well as quality assessment forms were valued and applied in the units appropriately and were also perceived to have an effect on the functioning, and quality, in the units.

Representations of work and worker in the three generations of knowledge management. Critical Discourse Analysis of selected texts.

The thesis studies the representations of different elements of contemporary work as present in Knowledge Management (KM). KM is approached as management discourse that is seen to affect and influence managerial practices in organizations. As representatives of KM discourse four journal articles are analyzed, using the methodology of Critical Discourse Analysis and the framework of Critical Management Studies, with a special emphasis on the question of structure and agency. The results of the analysis reveal that structural elements such as information technology and organizational structures are strongly present in the most influential KM representations, making their improvement also a desirable course of action for managers. In contrast agentic properties are not in a central role, they are subjugated to structural constraints of varying kind and degree. The thesis claims that one such constraint is KM discourse itself, influencing managerial and organizational choices and decision making. The thesis concludes that the way human beings are represented, studied and treated in management studies such as KM needs to be re-examined. Pro gradu-tutkielmassa analysoidaan työhön ja sen tekijään liittyviä representaatioita Tietojohtamisen kirjallisuudessa. Tietojohtamista tarkastellaan liikkeenjohdollisena diskurssina, jolla nähdään olevan vaikutus organisaatioiden päätöksentekoon ja toimintaan. Tutkielmassa analysoidaan neljä Tietojohtamisen tieteellistä artikkelia, käyttäen metodina kriittistä diskurssianalyysiä. Tutkielman viitekehyksenä on kriittinen liikkeenjohdon tutkimus. Lisäksi työssä pohditaan kysymystä rakenteen ja toimijan välisestä vuorovaikutuksesta. Tutkielman analyysi paljastaa, että tietojohtamisen vaikutusvaltaisimmat representaatiot painottavat rakenteellisia tekijöitä, kuten informaatioteknologiaa ja organisaatiorakenteita. Tämän seurauksena mm. panostukset em. tekijöihin nähdään organisaatioissa toivottavana toimintana. Vastaavasti representaatiot jotka painottavat yksilöitä ja toimintaa ovat em. tekijöille alisteisessa asemassa. Tapaa, jolla yksilöitä kuvataan ja käsitellään Tietojohtamisen diskurssissa, tulisikin laajentaa ja monipuolistaa.