Lääkevaihdon ja viitehintajärjestelmän vaikutukset patenttisuojattujen lääkevalmisteiden kohtuullisen tukkuhinnan vahvistamismenettelyyn

Pro gradu-tutkielman ensisijaisena tavoitteena oli selvittää, millaisia muutoksia lääkevaihto ja lääkkeiden viitehintajärjestelmä ovat aiheuttaneet patenttisuojattujen lääkevalmisteiden kohtuullisen tukkuhinnan vahvista-mismenettelyyn. Tätä menettelyä koskevat säännökset sisältyvät sairausvakuutuslain 6. lukuun, joten tutkimuksessa pyrittiin selvittämään kyseisen luvun soveltamista ja siinä mahdollisesti tapahtuneita muutoksia. Lääkevaihto otettiin Suomessa käyttöön 1.4.2003 ja viitehintajärjestelmä 1.4.2009. Lääkevalmisteiden hinnat ovat laskeneet niiden myötä merkittävästi. Tutkimusaineiston muodostivat 241 lääkkeiden hintalautakunnan sairausvakuutuskorvattavuutta ja kohtuullista tukkuhintaa koskevaa päätöstä vuosilta 2000-2010. Lisäksi käytössä oli muita päätöksiin liittyviä dokumentteja. Tutkimusaineisto lääkevaihdon käyttöönottoa edeltäneeltä ajalta jäi niukaksi. Tutkimuksen keskeiset havainnot liittyvätkin nimenomaan viitehintajärjestelmän käyttöönottoon. Nämä havainnot kuvaavat sitä, millaiset muutokset kohtuullisen tukkuhinnan vahvistamisessa ovat johtaneet patenttisuojattujen lääkevalmisteiden hintojen laskuun.

A Generic Framework Architecture for Portal Front End

A modem software development requires quick results and excellent quality, which leads to high demand for reusability in design and implementation of software components. The purpose of this thesis was to design and implement a reusable framework for portal front ends, including common portal features, such as authentication and authorization. The aim was also to evaluate frameworks as components of reuse and compare them to other reuse techniques. As the result of this thesis, a goo'd picture of framework's life cycle, problem domain and the actual implementation process of the framework, was obtained. It was also found out that frameworks fit well to solve recurrent and similar problems in a restricted problem domain. The outcome of this thesis was a prototype of a generic framework and an example application built on it. The implemented framework offered an abstract base for the portal front ends, using object-oriented methods and wellknown design patterns. The example application demonstrated the speed and ease of the application development based on the application frameworks.

Generic features of eighteenth-century American runaway slave advertisements

Pro-gradu –tutkielmani aiheena ovat 1700-luvun ”karanneet orjat” – sanomalehtiilmoitusten genrelle ominaiset piirteet. Tutkimusaineisto koostuu 190 ilmoituksesta, jotka ovat alkuperäisesti ilmestyneet virginialaisissa, pennsylvanialaisissa ja newyorkilaisissa sanomalehdissä 1730-luvulta 1770-luvulle. Tutkimuksen kohteeksi on rajattu ilmoitukset, joissa yksityishenkilöt ilmoittavat orjan/orjien karanneet ja lupaavat kiinniottajalle palkkion. Tutkielman tarkoituksena on tarkastella, millaisia ovat tyypilliset kielelliset piirteet näissä teksteissä ja millainen on prototyyppinen genren edustaja. Genreteorian lisäksi teoriaosuudessa käsittelen jonkin verran 1700- luvun englannin kielen yleisiä piirteitä sekä orjuuden ja sanomalehtien syntyhistoriaa Amerikassa taustoittaakseni tutkimusta. Analyysissa hyödynnän mm. Swalesin ja Bhatian käyttämää käsitettä siirroista (moves). Tutkin ilmoituksien tyypillistä rakennetta jakamalla ne yhdeksään siirtoon, joilla kaikilla on oma tehtävänsä ilmoituksessa. Jotkut siirrot, kuten karkulaisen kuvailu ja palkkion lupaaminen, esiintyvät kaikissa ilmoituksissa, kun taas toiset siirrot ovat läsnä harvemmin. Muita tälle genrelle tyypillisiä ominaisuuksia ovat esim. ilmoituksissa toistuvat kiinteät fraasit ja tietyt sanastolliset erikoisuudet. Lisäksi tutkin ilmoituksissa käytettäviä tapoja viitata asiaan liittyviin henkilöihin, sekä erilaisia toimia, joita ilmoitusten jättäjät ilmoituksien avulla suorittavat. Genressä on havaittavissa pieniä reilun neljänkymmenen vuoden kuluessa tapahtuneita muutoksia, mutta myös eroavaisuuksia eri siirtokuntien ilmoitusten välillä. Yleisesti voidaan todeta, että vaikka ”karanneet orjat” –ilmoitukset voivat vaihdella rakenteeltaan ja sanavalinnoiltaan, suuri osa ilmoituksista seuraa kuitenkin melko prototyyppistä muottia.

Generic and professional caring in a Chinese setting: an ethnopraphic study

The objective of the present study is to describe the cultural care practices, meanings, values and beliefs which form the basis of caring in a Chinese context. The research has its starting point in a caring science perspective and a qualitative research approach with interpretative ethnography as methodological guideline. The theoretical perspective is formed by elements of the theory of caritative caring, developed by Eriksson, and the theory of Culture Care Diversity and Universality, developed by Leininger. Previous research of suffering, culture and caring is described and also a presentation of actual transcultural nursing research as well as a presentation of the social structure dimensions of Chinese culture is included in the theoretical background. The empirical part includes patients and relatives, nurses and Hu Gongs as informants. The data collected are analysed based on Geertz’s idea of forming “thick descriptions” through examining the “what, how and why” of people’s actions. The findings show that the family has a prominent position in Chinese caring practices. The patient plays an unobtrusive role and a mutual dependence between the patient and the family members is evident. The professional nursing care is an extended act which includes the family in the caring relationship. The care practices of the Chinese nurse are characterized by great professional nursing skills. Suffering is described by the informants as being caused by disease, pain and social circumstances. “Social suffering” is described as worse than physical or mental suffering. Culturally competent and congruent care is a prerequisite for avoiding cultural pain, imposition and blindness when caring for the suffering human being. The findings of the present study necessitate a broadening in caring theory to include the family in the caring relationship. A further conclusion is that a broadening in our perception and understanding of culture would promote the delivery of culturally competent and congruent care. Suffering need to be seen as enclosed in cultural patterns of how it is expressed, interpreted, understood and relieved. Care and caring need to be seen as embedded in culture and the care practices values and beliefs have to be congruent with the cultural patterns where the care is provided.

Generic Life Cycle Cost Model and Cost-effective Solutions

Life cycle costing (LCC) practices are spreading from military and construction sectors to wider area of industries. Suppliers as well as customers are demanding comprehensive cost knowledge that includes all relevant cost elements through the life cycle of products. The problem of total cost visibility is being acknowledged and the performance of suppliers is evaluated not just by low acquisition costs of their products, but by total value provided through the life time of their offerings. The main purpose of this thesis is to provide better understanding of product cost structure to the case company. Moreover, comprehensive theoretical body serves as a guideline or methodology for further LCC process. Research includes the constructive analysis of LCC related concepts and features as well as overview of life cycle support services in manufacturing industry. The case study aims to review the existing LCC practices within the case company and provide suggestions for improvements. It includes identification of most relevant life cycle cost elements, development of cost breakdown structure and generic cost model for data collection. Moreover, certain cost-effective suggestions are provided as well. This research should support decision making processes, assessment of economic viability of products, financial planning, sales and other processes within the case company.

Comparison of Biomass Gasification Technologies for Natural Gas Substitution in Iron Ore Pelletizing Plants

The iron ore pelletizing process consumes high amounts of energy, including nonrenewable sources, such as natural gas. Due to fossil fuels scarcity and increasing concerns regarding sustainability and global warming, at least partial substitution by renewable energy seems inevitable. Gasification projects are being successfully developed in Northern Europe, and large-scale circulating fluidized bed biomass gasifiers have been commissioned in e.g. Finland. As Brazil has abundant biomass resources, biomass gasification is a promising technology in the near future. Biomasses can be converted into product gas through gasification. This work compares different technologies, e.g. air, oxygen and steam gasification, focusing on the use of the product gas in the indurating machine. The use of biosynthetic natural gas is also evaluated. Main parameters utilized to assess the suitability of product gas were adiabatic flame temperature and volumetric flow rate. It was found that low energy content product gas could be utilized in the traveling grate, but it would require burner’s to be changed. On the other hand, bio-SGN could be utilized without any adaptions. Economical assessment showed that all gasification plants are feasible for sizes greater than 60 MW. Bio-SNG production is still more expensive than natural gas in any case.

Development of Generic Simulation Model for Mobile Working Machines

This master’s thesis has been done for Drive! –project in which a new electric motor solution for mobile working machines is developed. Generic simulation model will be used as marketing and development tool. It can be used to model a wide variety of different vehicles with and without electric motor and to show customer the difference between traditionally build vehicles and those with new electric motor solution. Customers can also use simulation model to research different solutions for their own vehicles. At the start of the project it was decided that MeVEA software would be used as main simulation program and Simulink will only be used to simulate the operation of electrical components. Development of the generic model started with the research of these two software applications, simulation models which are made with them and how these simulation models can be build faster. Best results were used for building of generic simulation model. Finished generic model can be used to produce new tractor models for real-time simulations in short notice. All information about model is collected to one datasheet which can be easily filled by the user. After datasheet is filled a script will automatically build new simulation model in seconds. At the moment generic model is capable of building simulation models for wide variety of different tractors but it can be easily altered for other vehicle types too which would also benefit greatly from electric drive solution. Those could be for example wheel loaders and harvesters.