Sisäisen toimittajan palvelutasosopimuksen kehittäminen ja toimitusvarmuuden parantaminen, CASE: oy Shell ab

Tämän tutkielman tarkoituksena on tehostaa toimitusketjua kehittämällä palvelutasosopimusta ja parantamalla toimitusvarmuutta toimittajan ja oy Shell ab:n välillä. Työssä perehdytään näiden kahden yrityksen väliseen sopimukseen ja toimitusvarmuutta kuvaavaan mittariin nimeltä Supplier OTIF. Nykytila arvioidaan molempien osalta ja mahdollisia parantavia toimenpiteitä tuodaan esille. Tämä tutkimus perustuu yrityksessä työskentelyn ohella haastatteluihin, kyselyihin sekä omiin havaintoihin eri osastoilla. Työn teoriaosuudessa tarkastellaan ostosopimuksen yleisintä kaupallista sisältöä. Lisäksi paneudutaan palveluyrityksen käytäntöihin, tulkitaan palveluyrityksen suorituskykyä ja sen mittaamista tunnuslukujen avulla. Tutkimus osoittaa, että niin palvelutasosopimus kuin toimitusvarmuuskin eivät ole riittävällä tasolla case-yrityksessä. Erityisesti osapuolien välistä yhteistyötä ja tiedonjakoa on parannettava tavoitteiden saavuttamiseksi. Työssä esiteltyjen kehitys- ja parannusehdotusten osittainen käyttöönotto aikaansai toimitusketjun tehokkaamman toiminnan. Case-yrityksen tuleekin harkita lisätoimenpiteiden käyttöönottoa. Toiminnan sekä yhteistyön parantaminen yhä edelleen jää case-yrityksen ja toimittajien yhteisesti tulevaisuudessa tehtävien ratkaisujen varaan.

Customer Driven Order-to-Delivery Process

This thesis was made for a large forest industry company’s business segment. The purpose of the study was to improve the performance of the order-to-delivery process of the business segment. The study proceeded in three phases. The first phase was to define customer expectations in the market. The second phase was to analyse the performance and the operations of the order-to-delivery process, and to define any challenges or problems in serving the customers. The third and final phase was improving the performance of the order-to-delivery process, within the scope defined by the first two phases. The analysis showed that the delivery reliability is an essential but a challenging issue in the case company’s markets. On delivery reliability standpoint, the most challenging factors were the detected information flow distortions within the company as well as in the whole supply chain, and the lack of horizontal control over the multi-stage process.

Delivery, Outcome, and Costs of Orthodontic Care in Finnish Health Centres

The goal of the study was to analyse orthodontic care in Finnish health centres with special reference to the delivery, outcome and costs of treatment. Public orthodontic care was studied by two questionnaires sent to the chief dental officers of all health centres (n = 276) and to all specialist orthodontists in Finland (n = 146). The large regional variation was mentioned by the orthodontists as the most important factor requiring improvement. Orthodontic practices and outcome were studied in eight Finnish municipal health centres representing early and late timing of treatment. A random sample of 16- and 18-year-olds (n = 1109) living in these municipalities was examined for acceptability of occlusion with the Occlusal Morphology and Function Index (OMFI). In acceptability of occlusion, only minor differences were found between the two timing groups. The percentage of subjects with acceptable morphology was higher among untreated than among treated adolescents. The costs of orthodontic care were estimated among the adolescents with a treatment history. The mean appliance costs were higher in the late, and the mean visit costs higher in the early timing group. The cost-effectiveness of orthodontic services differed among the health centres, but was almost equal in the two timing groups. National guidelines and delegation of orthodontic tasks were suggested as the tools for reducing the variation among the health centres. In the eight health centres, considerable variation was found in acceptability of occlusion and in cost-effectiveness of services. The cost-effectiveness was not directly connected with the timing of treatment.

Applying organizational core values in everyday delivery work - case Accenture

The purpose of this thesis is to study organizational core values and their application in practice. With the help of literature, the thesis discusses the implementation of core values and the benefits that companies can gain by doing it successfully. Also, ways in which companies can improve their values’ application to their everyday work are presented. The case company’s value implementation is evaluated through a survey research conducted on their employees. The true power of values lies in their application, and therefore, core values should be the basis for all organizational behavior, integrated into everything a company does. Applying values in practice is an ongoing process and companies should continuously work towards creating a more value-based organizational culture. If a company does this effectively, they will most likely become more successful with stakeholders as well as financially. Companies looking to turn their values into actions should start with a self-assessment. Employee surveys are effective in assessing the current level of value implementation, since employees have valuable, first-hand information regarding the situations and behaviors they face in their everyday work. After the self-assessment, things like management commitment, communication, training, and support are key success factors in value implementation.

The Possibilities and Dosimetric Limitations of MLC-Based Intensity-Modulated Radiotherapy Delivery and Optimization Techniques

The use of intensity-modulated radiotherapy (IMRT) has increased extensively in the modern radiotherapy (RT) treatments over the past two decades. Radiation dose distributions can be delivered with higher conformality with IMRT when compared to the conventional 3D-conformal radiotherapy (3D-CRT). Higher conformality and target coverage increases the probability of tumour control and decreases the normal tissue complications. The primary goal of this work is to improve and evaluate the accuracy, efficiency and delivery techniques of RT treatments by using IMRT. This study evaluated the dosimetric limitations and possibilities of IMRT in small (treatments of head-and-neck, prostate and lung cancer) and large volumes (primitive neuroectodermal tumours). The dose coverage of target volumes and the sparing of critical organs were increased with IMRT when compared to 3D-CRT. The developed split field IMRT technique was found to be safe and accurate method in craniospinal irradiations. By using IMRT in simultaneous integrated boosting of biologically defined target volumes of localized prostate cancer high doses were achievable with only small increase in the treatment complexity. Biological plan optimization increased the probability of uncomplicated control on average by 28% when compared to standard IMRT delivery. Unfortunately IMRT carries also some drawbacks. In IMRT the beam modulation is realized by splitting a large radiation field to small apertures. The smaller the beam apertures are the larger the rebuild-up and rebuild-down effects are at the tissue interfaces. The limitations to use IMRT with small apertures in the treatments of small lung tumours were investigated with dosimetric film measurements. The results confirmed that the peripheral doses of the small lung tumours were decreased as the effective field size was decreased. The studied calculation algorithms were not able to model the dose deficiency of the tumours accurately. The use of small sliding window apertures of 2 mm and 4 mm decreased the tumour peripheral dose by 6% when compared to 3D-CRT treatment plan. A direct aperture based optimization (DABO) technique was examined as a solution to decrease the treatment complexity. The DABO IMRT technique was able to achieve treatment plans equivalent with the conventional IMRT fluence based optimization techniques in the concave head-and-neck target volumes. With DABO the effective field sizes were increased and the number of MUs was reduced with a factor of two. The optimality of a treatment plan and the therapeutic ratio can be further enhanced by using dose painting based on regional radiosensitivities imaged with functional imaging methods.

Assessment of pelvic floor by three-dimensional-ultrasound in primiparous women according to delivery mode: initial experience from a single reference service in Brazil

PURPOSE: To evaluate changes to the pelvic floor of primiparous women with different delivery modes, using three-dimensional ultrasound. METHODS: A prospective cross-sectional study on 35 primiparae divided into groups according to the delivery mode: elective cesarean delivery (n=10), vaginal delivery (n=16), and forceps delivery (n=9). Three-dimensional ultrasound on the pelvic floor was performed on the second postpartum day with the patient in a resting position. A convex volumetric transducer (RAB4-8L) was used, in contact with the large labia, with the patient in the gynecological position. Biometric measurements of the urogenital hiatus were taken in the axial plane on images in the rendering mode, in order to assess the area, anteroposterior and transverse diameters, average thickness, and avulsion of the levator ani muscle. Differences between groups were evaluated by determining the mean differences and their respective 95% confidence intervals. The proportions of levator ani muscle avulsion were compared between elective cesarean section and vaginal birth using Fisher's exact test. RESULTS: The mean areas of the urogenital hiatus in the cases of vaginal and forceps deliveries were 17.0 and 20.1 cm², respectively, versus 12.4 cm² in the Control Group (elective cesarean). Avulsion of the levator ani muscle was observed in women who underwent vaginal delivery (3/25), however there was no statistically significant difference between cesarean section and vaginal delivery groups (p=0.5). CONCLUSION: Transperineal three-dimensional ultrasound was useful for assessing the pelvic floor of primiparous women, by allowing pelvic morphological changes to be differentiated according to the delivery mode.

Obstetric outcomes in the second birth of women with a previous caesarean delivery: a retrospective cohort study from Peru

PURPOSE: To examine obstetric outcomes in the second birth of women who had undergone a previous cesarean delivery. METHODS: This was a large hospital-based retrospective cohort study. We included pregnant women who had a previous delivery (vaginal or cesarean) attending their second birth from 2001 to 2009. Main inclusion criteria were singleton pregnancies and delivery between a gestation of 24 and 41 weeks. Two cohorts were selected, being women with a previous cesarean delivery (n=7,215) and those with a vaginal one (n=23,720). Both groups were compared and logistic regression was performed to adjust for confounding variables. The obstetric outcomes included uterine rupture, placenta previa, and placental-related complications such as placental abruption, preeclampsia, and spontaneous preterm delivery. RESULTS: Women with previous cesarean delivery were more likely to have adverse outcomes such as uterine rupture (OR=12.4, 95%CI 6.8-22.3), placental abruption (OR=1.4, 95%CI 1.1-2.1), preeclampsia (OR=1.4, 95%CI 1.2-1.6), and spontaneous preterm delivery (OR=1.4, 95%CI 1.1-1.7). CONCLUSIONS: Individuals with previous cesarean section have adverse obstetric outcomes in the subsequent pregnancy, including uterine rupture, and placental-related disorders such as preeclampsia, spontaneous preterm delivery, and placental abruption.

Factors affecting immunoglobulin concentration in colostrum of healthy Holstein cows immediately after delivery

This study analyzed the influence of the number of milkings, number of births, and udder quarter in immunoglobulin (Ig) concentration in the colostrum of healthy Holstein cows. It was collected two samples of colostrum by manual milking, getting the first jets to completion of bacteriological examination and immunoglobulin levels by radial immunodiffusion test in agar gel. Positive samples for bacteriological examination were excluded from this investigation. Medians of immunoglobulin's G, A and M in the colostrum collected before the first and second milking were respectively 9,200 and 6,400mg/dL (p=0.0029); 400 and 200mg/dL (p=0.0018); 800 and 400mg/dL (p=0.0001). Median immunoglobulin concentration in animals that calved once, twice or three times or in cows that calved 4 to 6 times were 6,400; 6,400; 3,200 and 11,200mg/dL IgG; 100, 200, 100 and 800mg/dL IgA ; and 400, 400, 100 and 800mg/dL IgM, respectively. Concentrations of IgG, IgA and IgM were greater in animals that calved more than 4 times (p<0.05). Medians of IgG, IgA and IgM in the right fore quarter (RF), right hind quarter (RH), left fore quarter (LF) and left hind quarter (LH) were, respectively, 7,800; 6,400; 7,800 and 6,400mg/dL; 200, 200, 200 and 200mg/dL; and 400, 400, 400 and 400mg/dL. Ig concentrations in the colostrum of Holstein cows were influenced by the number of milkings after delivery and number of lactations. These variations may be considered risk factors to passive immunity transfer to newborn calves, predisposing them to diseases and causing economic losses to dairy production.

Service Productization and Product Servitization in The Contract Manufacturing Company

The role of contract manufacturing and subcontracting has been seen in black and white in product and service point of view. It used to be seen either as a product or a service. In the thesis product-service system, offering combining products and services, was discussed. Theory was created from two perspectives; Service productization via Business Model generation and product servitization via New Service Development process. Target for the case study was to point out new ways of service thinking and ways for changing business environment in contract manufacturing, especially in customer satisfaction and profitability point of view. The case study is following the New Service Development process phases. First ideas were collected from literature and via sales management interviews. Service offering and tool for service requirement evaluation was created. Last financial results of example service scenarios were calculated. It is recommended to take service offering into internal use and further develop it into modular service model. It is also recommended to take created customer service requirement evaluation tool into use for capturing customer service needs but also for communicating those internally.

Supplier Delivery Quality Evaluation in Maintenance Supporting Spare Part Business

The focus of this thesis is the issues related to the operational purchasing level supply chain process. Due to this limitation, the physical product quality issues do not belong to the primary concerns of this thesis, whereas the bilateral processes between the supplier and the purchasing organizations are of interest. Also, the issues related to the delivery timing are excluded from the study. Because the perspective is on the issues involved in the supply chain operations, the bilateral communication issues between supplier representative and purchaser are also considered.

Cesarean section - short term maternal complications related to the mode of delivery

Cesarean section (CS) is the most common major surgery performed on women worldwide. CS can save the life of the mother or the fetus, but is associated with the typical complications of any major surgery: hemorrhage, infection, venous thromboembolism and complications of anesthesia, sometimes leading to maternal death. Recently there have been several reports from well resourced countries on increased severe maternal morbidity and even mortality. Increased rates of CS, obesity and older mothers may explain this rise. The aim of this thesis is to study the rates and risk factors of short term maternal complications associated with CS. Also, we compared maternal morbidity by mode of delivery and over time. The complication rates were assessed in a prospective study involving 2496 CS performed in the 12 largest delivery units in Finland in 2005. The rates of severe complications were studied by mode of delivery in a register-based study comparing national cohorts in 1997 and 2002. The impact of several risk factors on severe maternal morbidity by mode of delivery was studied in a register-based study of all singleton deliveries in 2007-2011. In the prospective study, 27% of the women who underwent CS had one or more intraoperative or postoperative complications during their hospital stay, and 10% had a severe complication. In the register-based study the incidence of life-threatening maternal complications was 7.6 in 1000 deliveries. The incidence was lowest for vaginal delivery (VD), followed by instrumental VD and elective CS, and highest in emergency CS. An attempt of VD, including the risks associated with emergency CS, seems to be the safest mode of delivery, even for most high-risk women.

Elinkaarihankkeen rakennusliikeriskit

Tiivistelmä: Elinkaaren palvelumallit ovat suosittuja julkisten palveluiden hankintamuotoja Iso-Britanniassa. PPP–malli on yksi monista julkisten palvelujen kumppanuusmalleista, josta on tullut joissakin kunnissa yhä suositumpi hankintamalli myös Suomessa. Tämä on seurausta kuntien tiukasta taloustilanteesta, jossa PPP–hankkeen katsotaan mahdollistavan julkisen sektorin investoinnit joutumatta leikkaamaan muita pakollisia hankintoja. Kuitenkin koko elinkaaren kattavat palvelutarjonnan hankintamallit ovat vielä melko uusia malleja ja meillä on tarve löytää toimivia sopimusmalleja ja käytäntöjä, jotta hankkeista saadaan rakennusliikettä kiinnostavia liiketoimintamalleja. Ulkomailla elinkaarihankkeista on tehty monia tutkimuksia ja konsultit ovat kääntäneet niitä omiin tarkoituksiinsa sopiviksi. Kuitenkin Suomen lainsäädäntö on erilainen julkisten palveluiden tuottamisessa, erityisesti lakisääteisissä terveydenhuoltopalveluissa, vesi- ja jätevesihuollossa, vankeinhoidossa, ja niin edelleen. Tästä näkökulmasta ulkomailla tehdyt tutkimukset eivät sellaisenaan sovi Suomeen käytettäviksi. Esimerkiksi tutkimuksissa esitetään, että elinkaarihankkeet tuottavat pitkän aikavälin kassavirtaan, mutta tämä etu koskee vain rahoittaja ja kiinteistöpalvelu yrityksiä - ei rakennusyritystä. Tutkimuksissa mainitaan myös muista elinkaarihankkeiden mahdollisuuksista, jotka jäävät kuitenkin rakennusliikkeen näkökulmasta epäselviksi. Perinteisiin rakennuttamisen malleihin verrattuna elinkaarihankkeiden sopimusmenettelyt ovat monimutkaisempia sekä aikaa vievempiä ja sopijaosapuolten yhteistyö elinkaarihankkeissa on välttämätöntä. Käytännössä elinkaarihankkeiden riskienjako nähdään julkisen sektorin ja yksityisen sektorin välillä yksipuoliseksi. Jotta elinkaarimalli yleistyisi Suomessa, niin elinkaarisopimuksen riskienjaosta on tehtävä tasapuolinen ja käyttäjä pitää saada myös riskejä kantamaan. Tässä työssä keskitytään arvioimaan elinkaarimallien keskeisiä menestystekijöitä ja riskitekijöitä ja löytää mahdollisia tapoja tehdä hankintaprosessista helppoa ja sujuvaa. Samalla yritetään selvittää, miten elinkaarihankkeesta saadaan rakennusliikkeen kannalta menestyvää liiketoimintaa. Johtopäätökset perustuvat aikaisempiin tutkimuksiin ja empiiriseen tapaustutkimukseen. Työssä arvioidaan niitä seikkoja, jotka vaikuttavat yksityisen sektorin tarjouspäätökseen. Arvioinnissa erotetaan toisistaan kolme erillistä riskitekijää; tarjouksen tekemisen riskit, rakennushankkeen riskit ja elinkaaren aikaiset riskit. Työssä todetaan, että aikaisemmat tutkimukset ovat riittämättömiä rakennusliikkeen riskien arvioimiseen.

Building Dynamic Data Centers for Fast Delivery of New Data and Data Updates

Poster at Open Repositories 2014, Helsinki, Finland, June 9-13, 2014

Self-deposit, discovery, and delivery of scientific GIS datasets using GeoHydra

Presentation at Open Repositories 2014, Helsinki, Finland, June 9-13, 2014

Liposomes as a gene delivery system

Gene therapy is an active field that has progressed rapidly into clinical trials in a relatively short time. The key to success for any gene therapy strategy is to design a vector able to serve as a safe and efficient gene delivery vehicle. This has encouraged the development of nonviral DNA-mediated gene transfer techniques such as liposomes. Many liposome-based DNA delivery systems have been described, including molecular components for targeting given cell surface receptors or for escaping from the lysosomal compartment. Another recent technology using cationic lipids has been evaluated and has generated substantial interest in this approach to gene transfer.