Prevalence of child malnutrition at a university hospital using the World Health Organization criteria and bioelectrical impedance data

Malnutrition constitutes a major public health concern worldwide and serves as an indicator of hospitalized patients’ prognosis. Although various methods with which to conduct nutritional assessments exist, large hospitals seldom employ them to diagnose malnutrition. The aim of this study was to understand the prevalence of child malnutrition at the University Hospital of the Ribeirão Preto Medical School, University of São, Brazil. A cross-sectional descriptive study was conducted to compare the nutritional status of 292 hospitalized children with that of a healthy control group (n=234). Information regarding patients’ weight, height, and bioelectrical impedance (i.e., bioelectrical impedance vector analysis) was obtained, and the phase angle was calculated. Using the World Health Organization (WHO) criteria, 35.27% of the patients presented with malnutrition; specifically, 16.10% had undernutrition and 19.17% were overweight. Classification according to the bioelectrical impedance results of nutritional status was more sensitive than the WHO criteria: of the 55.45% of patients with malnutrition, 51.25% exhibited undernutrition and 4.20% were overweight. After applying the WHO criteria in the unpaired control group (n=234), we observed that 100.00% of the subjects were eutrophic; however, 23.34% of the controls were malnourished according to impedance analysis. The phase angle was significantly lower in the hospitalized group than in the control group (P<0.05). Therefore, this study suggests that a protocol to obtain patients’ weight and height must be followed, and bioimpedance data must be examined upon hospital admission of all children.

Software business expansion through distribution channel : Case M-Files - Denmark

The purpose of this study was to find out how a software company can successfully expand business to the Danish software market through distribution channel. The study was commissioned by a Finnish software company and it was conducted using a qualitative research method by analyzing external and internal business environment, and interviewing Danish ICT organizations and M-Files personnel. Interviews were semi-structured interviews, which were designed to collect comprehensive information on the existing ICT and software market in Denmark. The research used three external and internal analyzing frameworks; PEST analysis (market level), Porter´s Five Force analysis (industry level competition) and SWOT analysis (company level). Distribution channels theory was a base to understand why and what kind of distribution channels the case company uses, and what kind of channels target markets companies’ uses. Channel strategy and design were integrated to the industry level analysis. The empirical findings revealed that Denmark has very business friendly ICT environment. Several organizations have ranked Denmark´s information and communication technology as the best in the world. Denmark’s ICT and software market are relatively small, compared to many other countries in Europe. Danish software market is centralized. Largest software clusters are in the largest cities; Copenhagen, Aarhus, Odense and Aalborg. From these clusters, software companies can most likely find suitable resellers. The following growing trends are clearly seen in the software market: mobile and wireless applications, outsourcing, security solutions, cloud computing, social business solutions and e-business solutions. When expanding software business to the Danish market, it is important to take into account these trends. In Denmark distribution channels varies depending on the product or service. For many, a natural distribution channel is a local partner or internet. In the public sector solutions are purchased through a public procurement process. In the private sector the buying process is more straight forwarded. Danish companies are buying software from reliable suppliers. This means that they usually buy software direct from big software vendors or local partners. Some customers prefer to use professional consulting companies. These consulting companies can strongly influence on the selection of the supplier and products, and in this light, consulting companies can be important partners for software companies. Even though the competition is fierce in ECM and DMS solutions, Danish market offers opportunities for foreign companies. Penetration to the Danish market through reseller channel requires advanced solutions and objective selection criteria for channel partners. Based on the findings, Danish companies are interested in advanced and efficient software solutions. Interest towards M-Files solutions was clearly seen and the company has excellent opportunity to expand business to the Danish market through reseller channel. Since the research explored the Danish ICT and software market, the results of the study may offer valuable information also to the other software companies which are expanding their business to the Danish market.

Corporate social responsibility in procurement: environmentally responsible practices case study

The main object of this study is to find and define environmentally responsible procurement practices and characterize responsible procurement.

Safety criteria for the acquisition of meat in Brazilian University restaurants

The present study's objective was to analyze the procedures aimed at guaranteeing sanitary conditions when acquiring meat. The study was conducted with university restaurants of the Federal Institutions of Higher Education (IFES) located in the five regions of Brazil. Data were collected using a questionnaire and an evaluation list, which was available online to restaurant professionals. The results showed that restaurants chose one or two types of meat, the most frequent of which were beef and chicken. In restaurants managed by the IFES, the acquisition of raw material occurred by bidding. For vendor selection, the restaurants required product registration with the Inspection Service and requested regulation of the supplier by the Health Surveillance. Monitoring was carried out through a technical visit to the supplier and a review of the past records of the supplier. A higher percentage of restaurants in the Southeast region met appropriate sanitary and hygienic criteria for the receipt of meat, followed by the South, Midwest, Northeast and North. We conclude that restaurants meet most of the safety criteria set in the legislation. However, some weaknesses are evident in the physical and functional structure, the system of transportation of raw material and the records of control measures at the place of reception.

Analysis of Phase Separator Design Criteria Using Computational Fluid Dynamics

Gravitational phase separation is a common unit operation found in most large-scale chemical processes. The need for phase separation can arise e.g. from product purification or protection of downstream equipment. In gravitational phase separation, the phases separate without the application of an external force. This is achieved in vessels where the flow velocity is lowered substantially compared to pipe flow. If the velocity is low enough, the denser phase settles towards the bottom of the vessel while the lighter phase rises. To find optimal configurations for gravitational phase separator vessels, several different geometrical and internal design features were evaluated based on simulations using OpenFOAM computational fluid dynamics (CFD) software. The studied features included inlet distributors, vessel dimensions, demister configurations and gas phase outlet configurations. Simulations were conducted as single phase steady state calculations. For comparison, additional simulations were performed as dynamic single and two-phase calculations. The steady state single phase calculations provided indications on preferred configurations for most above mentioned features. The results of the dynamic simulations supported the utilization of the computationally faster steady state model as a practical engineering tool. However, the two-phase model provides more truthful results especially with flows where a single phase does not determine the flow characteristics.

Development of Project Logistics in Engineering, Procurement and Construction Projects

The aim of this Master’s Thesis is to develop project logistics functions in large scale en-gineering, procurement and construction projects. The background of the research topic is compounded from two separate subjects; OPAL Program and case study of an actual EPC project. The purpose is to examine Project Logistics process in accordance with OPAL Program as well as logistics process in focus EPC project. Both entities are researched by using the case study research methodology. Logistics process of the focus EPC project is described as well as presented and in addi-tion, logistics related findings and observations are introduced. Significant findings and observations are found from logistics costs as well as shipment volume estimations in the early phase of the focus ECP project. A notable finding is also that because goods were transported as readily assembled as possible it caused expensive oversized cargo deliveries. From findings and observation of the focus EPC project it can be derived that logistics has to be involved in the early sales phase in order to receive more accurate logistics cost esti-mations for project deliveries. It is also noticed that in order to obtain savings in logistics costs, oversized deliveries must be avoided.

Foreign exchange exposure management in a fuel procurement company operating in the commodity markets

Fluctuating commodity prices, foreign exchange rates and interest rates are causing changes in cash flows, market value and the companies’ profit. Most of the commodities are quoted in US dollar. Companies with non-dollar accounting face a double risk in the form of the commodity price risk and foreign exchange risk. The objective of this Master’s thesis is to find out how companies under commodity should manage foreign exchange exposure. The theoretical literature is based on foreign exchange risk, commodity risk and foreign exchange exposure management. The empirical research is done by using constructive modelling of a case company in the oil industry. The exposure is model with foreign exchange net cash flow and net working capital. First, the factors affecting foreign exchange exposure in case company are analyzed, then a model of foreign exchange exposure is created. Finally, the models are compared and the most suitable method is defined. According to the literature, foreign exchange exposure is the foreign exchange net cash flow. However, the results of the study show that foreign exchange risk can be managed also with net working capital. When the purchases, sales and storage are under foreign exchange risk, the best way to manage foreign exchange exposure is with combined net cash flow and net working capital method. The foreign exchange risk policy of the company defines the appropriate way to manage foreign exchange risk.

Non-offensive defence : a criteria model of military credibility

Finnish Defence Studies is published under the auspices of the War College, and the contributions reflect the fields of research and teaching of the College. Finnish Defence Studies will occasionally feature documentation on Finnish Security Policy. Views expressed are those of the authors and do not necessarily imply endorsement by the War College.

Julkisten kansallisten palveluhankintojen tarjouspyyntöjen laatimisen ongelmakohdat

Viime vuosien aikana palveluhankintojen suhteellinen osuus kaikista toteutetuista julkisista hankinnoista on kasvanut Suomessa huomattavasti. Samalla markkinaoikeudessa on käsitelty vuosittain suuri määrä erilaisiin julkisiin hankinta-asioihin liittyviä valituksia. Merkittävä valitusten määrä on seurausta siitä, että julkisissa hankintaprosesseissa tehdään paljon virheitä. Tarjouspyynnön laatiminen on tärkeä hankintaprosessin vaihe, johon hankintayksiköissä tulisi kalliit markkinaoikeuskäsittelyt välttääkseen riittävästi panostaa. Tämän tutkielman tavoitteena oli selvittää, mitkä asiat palveluhankintojen tarjouspyyntöjen laatimisessa tuottavat hankintayksiköille ongelmia. Lisäksi tarkoituksena oli pohtia sekä itse palvelun hankkijaan että julkisten hankintojen lainsäädäntöön liittyviä tekijöitä, joista ongelmat palveluhankintojen tarjouspyyntöjen laatimisessa mahdollisesti johtuvat. Tutkimuksessa tutkimuskohteena olivat 24 markkinaoikeuden vuosina 2012–2014 antamaa hankinta-asioiden ratkaisua, ja tutkimus toteutettiin kvalitatiivisena tutkimuksena tutkimusaineistoa kategorisoimalla ja yhdenmukaistamalla. Tutkielmassa havaittiin, että merkittävin kompastuskivi kansallisten palveluhankintojen tarjouspyyntöjen laatimisessa on tarjouksen vertailuperusteiden asettaminen. Erityisesti laadun vertailuperusteiden tulkinnanvarainen ja epäselvä esittäminen oli yleistä, ja lisäksi merkittävä määrä virheitä tehtiin sekoittamalla tarjoajan soveltuvuusvaatimukset vertailuperusteisiin. Joitakin virheitä tehtiin myös vertailuperusteiden tärkeysjärjestyksen ja suhteellisen painotuksen asettamisessa sekä hankinnan kohteen määrittelyssä. Tutkimustulosten perusteella pääteltiin, että kansallisten palveluhankintojen tarjouspyyntöjen laatimisen ongelmissa on suurimmassa osin kyse hankintayksikön vähäisistä resursseista ja siten heikosta hankintojen suunnittelusta sekä hankintayksiköiden ammattitaidon ja kokemuksen puutteista. Lisäksi joitakin esiintyneitä virheitä voidaan ainakin jossain määrin perustella hankintalainsäädännön monimutkaisuudella ja tulkinnanvaraisuudella.

Ekologisuuden merkitys julkisissa hankinnoissa

Ilmastonmuutos, ympäristön saastuminen sekä luonnonvarojen ehtyminen lukeutuvat voimakkaimpiin taustalla vaikuttaviin tekijöihin, joiden vuoksi ympäristönäkökohdat ovat nousseet yhä voimakkaammin esille julkisissa hankinnoissa. Julkisten hankintojen tekijät ovat velvoitettuja huomioimaan talouden ohella myös ympäristönäkökohdat. Suuren ostovolyyminsa vuoksi julkinen sektori voi toimia suunnannäyttäjänä ympäristöä säästävien hankintojen toteuttajana. Tämä Pro gradu –tutkielma kartoittaa ekologisten hankintojen merkitystä suomalaisissa kunnissa vuonna 2016. Tavoitteena on selvittää mitä julkisten hankintojen ekologisuus kunnille merkitsee, miten ekologisuus näkyy hankintaprosessissa sekä mitkä tekijät ovat ekologisten hankintojen esteenä ja mitkä tekijät puolestaan kannustavat kuntia tekemään ekologisia hankintoja. Tutkimuksen tuloksena selvisi, että kunnat suhtautuvat ekologisuuteen hankinnoissa varsin positiivisesti ja ennen kaikkea ympäristönäkökohdat koetaan tärkeänä osana hankintoja. Ympäristönäkökohtien huomioiminen hankintaprosessissa koetaan kuitenkin melko vaikeaksi. Erityisesti tiedon puute, hinta ja taloudelliset resurssit vaikeuttavat ekologisten hankintojen toteutusta. Positiivisesti ympäristönäkökohtien huomioimiseen hankinnoissa puolestaan vaikuttavat henkilöstön osaaminen, taloudellisuus ja lainsäädäntö.

Armourstone revetments : will standard design criteria prevent failure? /

Bank stabilization structures are used to prevent the loss of valuable land within the urban environment and the decision for the type of structure used depends on the properties of the stream. In the urban areas of Southern Ontario there is a preference for the use of armourstone blocks as bank stabilization. The armourstone revetment is a free standing stone structure with large blocks of stone layered vertically and offset from one another. During fieldwork at Forty Mile Creek in Grimsby, Ontario armourstone failure was identified by the removal of two stones within one column from the wall. Since the footer stones were still in place, toe scour was eliminated as a cause of failure. Through theoretical, field, and experimental work the process of suction has been identified as a mode of failure for the armourstone wall and the process of suction works similarly to quarrying large blocks of rock off bedrock streambeds. The theory of lateral suction has previously not been taken into consideration for the design of these walls. The physical and hydraulic evidence found in the field and studied during experimental work indicate that the armourstone wall is vulnerable to the process of suction. The forces exerted by the flow and the resistance of the block determine the stability of the armourstone block within the wall. The design of the armourstone wall, high surface velocities, and short pulses of faster flowing water within the profile could contribute to armourstone failure by providing the forces needed for suction to occur, therefore adjustments to the design of the wall should be made in order to limit the effect.

Elementary computer-mediated online distance education : identification of criteria for successful implementation and practice

This study had three purposes related to the effective implem,entation and practice of computer-mediated online distance education (C-MODE) at the elementary level: (a) To identify a preliminary framework of criteria 'or guidelines for effective implementation and practice, (b) to identify areas ofC-MODE for which criteria or guidelines of effectiveness have not yet been developed, and (c) to develop an implementation and practice criteria questionnaire based on a review of the distance education literature, and to use the questionnaire in an exploratory survey of elementary C-MODE practitioners. Using the survey instrument, the beliefs and attitudes of 16 elementary C'- MODE practitioners about what constitutes effective implementation and practice principles were investigated. Respondents, who included both administrators and instructors, provided information about themselves and the program in which they worked. They rated 101 individual criteria statenlents on a 5 point Likert scale with a \. point range that included the values: 1 (Strongly Disagree), 2 (Disagree), 3 (Neutral or Undecided), 4 (Agree), 5 (Strongly Agree). Respondents also provided qualitative data by commenting on the individual statements, or suggesting other statements they considered important. Eighty-two different statements or guidelines related to the successful implementation and practice of computer-mediated online education at the elementary level were endorsed. Response to a small number of statements differed significantly by gender and years of experience. A new area for investigation, namely, the role ofparents, which has received little attention in the online distance education literature, emerged from the findings. The study also identified a number of other areas within an elementary context where additional research is necessary. These included: (a) differences in the factors that determine learning in a distance education setting and traditional settings, (b) elementary students' ability to function in an online setting, (c) the role and workload of instructors, (d) the importance of effective, timely communication with students and parents, and (e) the use of a variety of media.

In danger of jammed minds: A deconstructive discourse analysis of the criteria for early onset schizophrenia and imagination in children's literature

The purpose of this research is to expose and complicate those discourses of childhood imagination as demonstrated in the diagnostic criteria for early onset schizophrenia by using an antipsychiatry perspective. This will be done by evaluating those discourses alongside those found in popular children’s literature, specifically, Harry Potter and The Philosopher’s Stone, Bridge to Terabithia, and A Wrinkle in Time. Once uncovered, the underlying power discourses were then exposed. This research will then employ a minor reading as provided by Deleuze and Guattari’s (1987) approach to minor literature to demonstrate the ways in which the child can subvert those dominant discourses. The potential of literature is evaluated for its ability to provide alternative modes of experience and lines of flight for the child subjected to the diagnostic criteria of schizophrenia.