Évaluation d'une structure gériatrique entre l'ambulatoire et l'hospitalier [Geriatric institutions, between ambulatory and hospital care: patients' description and performance assessment].

Introduction : Décrire les patients d'une structure gériatrique offrant des hospitalisations de courte durée, dans un contexte ambulatoire, pour des situations gériatriques courantes dans le canton de Genève (Suisse). Mesurer les performances de cette structure en termes de qualité des soins et de coûts. Méthodes : Des données relatives au profil des 100 premiers patients ont été collectées (huit mois), ainsi qu'aux prestations, aux ressources et aux effets (réadmissions, décès, satisfaction, complications) de manière à mesurer différents indicateurs de qualité et de coûts. Les valeurs observées ont été systématiquement comparées aux valeurs attendues, calculées à partir du profil des patients. Résultats : Des critères d'admission ont été fixés pour exclure les situations dans lesquelles d'autres structures offrent des soins mieux adaptés. La spécificité de cette structure intermédiaire a été d'assurer une continuité des soins et d'organiser d'emblée le retour à domicile par des prestations de liaison ambulatoire. La faible occurrence des réadmissions potentiellement évitables, une bonne satisfaction des patients, l'absence de décès prématurés et le faible nombre de complications suggèrent que les soins médicaux et infirmiers ont été délivrés avec une bonne qualité. Le coût s'est révélé nettement plus économique que des séjours hospitaliers après ajustement pour la lourdeur des cas. Conclusion : L'expérience-pilote a démontré la faisabilité et l'utilité d'une unité d'hébergement et d'hospitalisation de court séjour en toute sécurité. Le suivi du patient par le médecin traitant assure une continuité des soins et évite la perte d'information lors des transitions ainsi que les examens non pertinents. INTRODUCTION: To describe patients admitted to a geriatric institution, providing short-term hospitalizations in the context of ambulatory care in the canton of Geneva. To measure the performances of this structure in terms of quality ofcare and costs. METHOD: Data related to the clinical,functioning and participation profiles of the first 100 patients were collected. Data related to effects (readmission, deaths, satisfaction, complications), services and resources were also documented over an 8-month period to measure various quality and costindicators. Observed values were systematically compared to expected values, adjusted for case mix. RESULTS: Explicit criteria were proposed to focus on the suitable patients, excluding situations in which other structures were considered to be more appropriate. The specificity of this intermediate structure was to immediately organize, upon discharge, outpatient services at home. The low rate of potentially avoidable readmissions, the high patient satisfaction scores, the absence of premature death and the low number of iatrogenic complications suggest that medical and nursing care delivered reflect a good quality of services. The cost was significantly lower than expected, after adjusting for case mix. CONCLUSION: The pilot experience showed that a short-stay hospitalization unit was feasible with acceptable security conditions. The attending physician's knowledge of the patients allowed this system tofocus on essential issues without proposing inappropriate services.

Description and implementation of cut calculation-method in a sawmill

Työn tavoitteena oli kuvata ja ottaa käyttöön sahauseräkohtaisen kannattavuuden laskentamenetelmä sahalle, sekä tehdä laskentamalli menetelmän tueksi. Sahauksen peruskäsitteiden jälkeen työssä on esitelty sahan tuotantoprosessi. Tuotantoprosessi on kuvattu kirjallisuuden ja asiantuntijoiden haastattelujen perusteella. Seuraavaksi kartoitettiin hyötyjä ja vaikutuksia, mitä laskentamenetelmältä odotetaan.. Kustannuslaskennan teoriaa selvitettiin kirjallisuuslähteitä käyttäen silmälläpitäen juuri tätä kehitettävää laskentamenetelmää. Lisäksi esiteltiin Uimaharjun sahalla käytettävät ja laskentaan liittyvät laskenta- ja tietojärjestelmät.Nykyisin sahalla ei ole minkäänlaista menetelmää sahauseräkohtaisen tuloksen laskemiseksi. Pienillä muutoksilla sahan tietojärjestelmään ja prosessikoneisiin voidaan sahauserä kuljettaa prosessin läpi niin, että jokaisessa prosessin vaiheessa sille saadaan kohdistettua tuotantotietoa. Eri vaiheista saatua tietoa käyttämällä saadaan tarkasti määritettyä tuotteet, joita sahauserä tuotti ja paljonko tuotantoresursseja tuottamiseen kului. Laskentamalliin syötetään tuotantotietoja ja kustannustietoa ja saadaan vastaukseksi sahauserän taloudellinen tulos.Toimenpide ehdotuksena esitetään lisätutkimusta tuotantotietojen automaattisesta keräämisestä manuaalisen työn ja virheiden poistamiseksi. Suhteellisen pienillä panoksilla voidaan jokaiselle sahauserälle kerätä tuotantotiedot täysin automaattisesti. Lisäksi kehittämäni laskentamallin tilalle tulisi hankkia sovellus, joka käyttäisi paremmin hyväksi nykyisiä tietojärjestelmiä ja poistaisi manuaalisen työvaiheen laskennassa.

Present day distribution and historical biogeography of the tribu Ophidiini (Ophidiformes, Ophidiidae, Ophidiinae) from the East Tropical Atlantic (CLOFETA area) and North-East Atlantic and Mediterranean (CLOFNAM area)

The present day geographic distribution of the Ophidiini tribe (Ophidiidae, Ophidiinae) in the Clofnam (North- Eastern Atlantic and Mediterranean) and Clofeta (Eastern Tropical Atlantic) areas is revised in this paper. Results show that Parohidion vassali is not a Mediterranean endemic species, and the presence of Ophidion barbatum in the Atlantic is confirmed. Moreover, the paper tries to analyse the historical events which could have caused the present situation of two genera, Ophidion and Parophidion, both in the Atlantic and in the Mediterranean. Although first fossil records of Ophidion and Parophidion date from the Pliocene, when considering all the historical events occurred from the existence of the Tethys Sea to the opening of the Atlantic and the Mediterranean formation, a much earlier origin of these genera seems to be more likely. The situation of Ophidion barbatum and O. rochei in the Mediterranean and Black Sea is also discussed

A long way to the rainbow country : understanding the foreign market expansion process of Finnish corporations into the Republic of South Africa between 1999 and 2005

De afrikanska ekonomierna växer med nära fyra procent per år och detta är en god indikation på kontinentens växande betydelse. Under kalla kriget hade afrikanska regeringar haft ett begränsat utrymme för opportunistisk köpslående, och därmed även en marginal att positionera sig strategiskt. Alltför ofta uppmuntrade och beskyddade stormakterna diktatorer och små lokala eliter som främst ville berika sig själv. I och med att globaliseringen tog fart och USA allt mera kom att dominera globalt, började en ny era i fråga om förändringar. Trots dessa förändringar på den globala arenan, har Afrika som kontinent hamnat i bakgrunden och jämfört med andra utvecklingsländer har Afrika attraherat ett fåtal utländska investeringar. Fortfarande, speciellt i Norden, finns det lite kunskap om hur utländska företag expanderar sin affärsverksamhet på den afrikanska kontinenten. Det råder brist på empiriska undersökningar om vilken inverkan afrikanska institutionella förändringar och lokala affärsmiljöer har på internationaliseringen och på de utländska företagens affärsutvecklingsstrategier på den afrikanska kontinenten. Med denna avhandling vill jag lyfta fram ett exempel på ett land (Sydafrika), som har lyckat dra nytta av de förändringar som 1990-talet förde med sig. I denna avhandling har jag intervjuat olika personer i ledande positioner inom olika finländska företag i Finland och i Sydafrika. Avhandlingen skapar en referensram för att öka förståelse och fördjupa analys av hur en kombination av olika interna och externa resurser ökar företagens konkurrenskraft och på det sättet bidrar till en framgångsrik affärsutveckling i Afrika. De politiska och sociala aktörerna samt aktörerna inom affärslivet besitter resurser som ambitiösa företag kan dra nytta av i sin strävan att erövra de nya framgångsrika marknaderna i Afrika. Gradvis ökar finländska företag sina insatser på den afrikanska kontinenten i strävan att skapa mervärde för sina kunder. Den värdeskapande processen gör att parterna måste närma sig varandra utgående från sina egna strategiska målsättningar. Hittills har finländska företag varit intresserad att sälja till Afrika men inte intresserad att köpa därifrån. Förutom de praktiska råden till olika företag, föreslår avhandlingen hur den finska staten och den sydafrikanska staten kunde agera tillsammans för att främja ömsesidigt handelsutbyte.

The history of Lapland : containing a geographical description, and a natural history of that country; with an account of the inhabitants, their original, religion, customs, habits, marriages, conjurations, employments, &c. Written by John Scheffer, ... Translated from the last edition in Latin, and illustrated with many curious copper-cutts. To which are added, the travels of the King of Sweden's mathematicians into Lapland: the history of Livonia, and the wars there: also a journey into Lapland, Finland, &c. Written by Dr. Olof Rudbeck in the year 1701

Added engraved title page: The history of Lapland.

Computational modeling for irrigated agriculture planning. Part I: general description and linear programming

Linear programming models are effective tools to support initial or periodic planning of agricultural enterprises, requiring, however, technical coefficients that can be determined using computer simulation models. This paper, presented in two parts, deals with the development, application and tests of a methodology and of a computational modeling tool to support planning of irrigated agriculture activities. Part I aimed at the development and application, including sensitivity analysis, of a multiyear linear programming model to optimize the financial return and water use, at farm level for Jaíba irrigation scheme, Minas Gerais State, Brazil, using data on crop irrigation requirement and yield, obtained from previous simulation with MCID model. The linear programming model outputted a crop pattern to which a maximum total net present value of R$ 372,723.00 for the four years period, was obtained. Constraints on monthly water availability, labor, land and production were critical in the optimal solution. In relation to the water use optimization, it was verified that an expressive reductions on the irrigation requirements may be achieved by small reductions on the maximum total net present value.

RDA (Resource Description and Access) – kuvailuohjeiden kansainvälinen ja kansallinen käyttöönotto

Marjatta Autio-Tuulen esitys Kuvailun tiedotuspäivillä Helsingissä 20.3.2013.

Systematization, description and territory of the caudal cerebral artery of the brain in broad-snouted Caiman (Caiman latirostris)

Thirty heads with the neck segment of Caiman latirostris were used. The animals were provided from a creation center called Mister Caiman, under the authorization of the Brazilian Institute of Environment and Renewable Natural Resources (Ibama). Animals were sacrificed according to the slaughtering routine of the abattoir, and the heads were sectioned at the level of the third cervical vertebra. The arterial system was washed with cold saline solution, with drainage through jugular veins. Subsequently, the system was filled with red colored latex injection. Pieces were than fixed in 20% formaldehyde, for seven days. The brains were removed, with a spinal cord segment, the duramater removed and the arteries dissected. At the level of the hypophysis, the internal carotid artery gave off a rostral branch, and a short caudal branch, continuing, naturally, as the caudal cerebral artery. This artery projected laterodorsalwards and, as it overpassed the optic tract, gave off its I (the first) central branch. Penetrated in the cerebral transverse fissure, emitting the diencephalic artery and next its II (second) central branch. Still inside the fissure, originated occipital hemispheric branches and a pineal branch. Emerged from the cerebral transverse fissure, over the occipital pole of the cerebral hemisphere. Projected rostralwards, sagital to the cerebral longitudinal fissure, as interhemispheric artery. This artery gave off medial and convex hemispheric branches to the respective surfaces of the cerebral hemispheres, anastomosed with its contralateral homologous, forming the common ethmoidal artery. This artery entered the fissure between the olfactory peduncles, emerging ventrally and dividing into ethmoidal arteries, right and left, which progressed towards the nasal cavities, vascularizing them. The territory of the caudal cerebral artery included the most caudal area of the base of the cerebral hemisphere, its convex surface, the olfactory peduncles and bulbs, the choroid plexuses and the diencephalus with its parietal organs.

Niagara Resort and Tourist Association Records, 1975-1976, 1978-1983, 1985, 1987-1989, n.d.

Ontario Editorial Bureau (O.E.B.)

Rainfall Climatology over Middle East Region and its Variability

A better understanding of the rainfall climatology of the Middle East region identifying the mechanisms responsible for the rain producing systems is essential for effective utilization of the water resources over the arid region. A comprehensive analysis on the rainfall climatology of the Middle East region is carried out to bring out the spatial and temporal variation of rainfall and mechanisms responsible for the rain events. The study was carried out utilizing rainfall, OLR, wind and humidity data sets procured from TRMM, NOAA and NCEP-NCAR. Climatology of annual rainfall brings out two areas of alarmingly low rainfall in the Middle East region: one in Egypt, Jordan and adjoining areas and the other in the southern part of Saudi Arabia. Daily rainfall analysis indicates that northern region gets rainfall mainly during winter and spring associated with the passage of Mediterranean low pressure systems whereas rain over the southern region is caused mainly by the monsoon organized convection, cross equatorial flow and remnants of low pressure systems associated with the monsoon during the summer season. Thermodynamic structure of the atmosphere reveals that the region does not have frequent local convection due to insufficient moisture content. The sinking motion associated with the sub tropic high pressure system and subsidence associated with the Walker circulation are responsible for maintaining warm and dry air over the region.

Description and analysis of pulmonary rehabilitation care programs current state in four cities of Colombia

Purpose: there are many studies reporting the benefits of pulmonary rehabilitation, but few of them exhibit the behavior and activities of these services. This article presents the characteristics of services, parts management and training level of team members, in addition to the variables or instruments used to measure the effectiveness and impact in these programs. Method: it was made a cross sectional convenience sample which included seven pulmonary rehabilitation services in four Colombian cities (Bogotá, Medellín, Manizales and Cali), selected by the coverage, for having at least one year of experience and for being formally established and recognized nationwide. The interdisciplinary team of each service answered a survey that was validated through a pilot test and expert consensus. Participation was voluntary. Results: labor onset pulmonary rehabilitation services correspond to an average of a decade, with COPD and asthma pathologies of attention. The programs are characterized by an outpatient treatment with an average duration of eight to twelve weeks, with a frequency of an hour three times a week. Also, the director of the service is regularly a pulmonologist and the coordinator a physiotherapist (57.14%). The posgradual training of these professionals is notable, and they report to have procedural, administrative and communicative skills, but qualify regular there research skills. The physical and technological resources are well tested. 71.42% have done impact studies, but only 28.57% have been published. All have in common training in upper limbs, lower limbs, respiratory muscles, counseling, functional assessment and quality of life. The effectiveness and impact of programs is measured by the walking test, quality of life questionnaires and activities of daily living.