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.

Costs and Benefits of a Shared Digital Long-Term Preservation System

Paper presented at the 40th Annual Conference of LIBER (Ligue des Bibliothèques Européennes de Recherche - Association of European Research Libraries) on July 1st, 2011; with the slides used at the presentation.

Costs and Benefits of a Shared Digital Long-Term Preservation System

This paper describes the cost-benefit analysis of digital long-term preservation (LTP) that was carried out in the context of the Finnish National Digital Library Project (NDL) in 2010. The analysis was based on the assumption that as many as 200 archives, libraries, and museums will share an LTP system. The term ‘system’ shall be understood as encompassing not only information technology, but also human resources, organizational structures, policies and funding mechanisms. The cost analysis shows that an LTP system will incur, over the first 12 years, cumulative costs of €42 million, i.e. an average of €3.5 million per annum. Human resources and investments in information technology are the major cost factors. After the initial stages, the analysis predicts annual costs of circa €4 million. The analysis compared scenarios with and without a shared LTP system. The results indicate that a shared system will have remarkable benefits. At the development and implementation stages, a shared system shows an advantage of €30 million against the alternative scenario consisting of five independent LTP solutions. During the later stages, the advantage is estimated at €10 million per annum. The cumulative cost benefit over the first 12 years would amount to circa €100 million.

Medico-legal litigation in Obstetrics: a characterization analysis of a decade in Portugal

PURPOSE: It was to analyse the most critical areas in Obstetrics and to suggest measures to reduce or avoid the situations most often involved in these disputes. METHODS: Obstetrics cases submitted to the Medico-legal Council since the creation of the National Institute of Legal Medicine and Forensic Sciences in 2001 until 2011 were evaluated. A comprehensive characterization, determination of absolute/relative frequencies, hypothesis of a linear trend over the years and the association between each parameter was done. RESULTS: The analysis has shown no significantly linear trend. The most common reasons for disputes were perinatal asphyxia (50%), traumatic injuries of the newborn (24%), maternal sequelae (19%) and issues related to prenatal diagnosis and/or obstetric ultrasound (5.4%). Perinatal asphyxia showed no significantly linear trend (p=0.58) and was usually related to perinatal deaths or permanent neurologic sequelae in newborn children. Traumatic injuries of the newborn, mostly related to instrumented deliveries, shoulder dystocia or vaginal delivery in breech presentation, has shown a significantly increased linear trend (p<0.001), especially related to instrumented deliveries. The delay/absence of cesarean section was the clinical procedure questioned in a significantly higher number of cases of perinatal asphyxia (68.7%) and of traumatic lesions of the newborn due to instrumented deliveries (20.5%). CONCLUSION: It is important to improve and correct theoretical/practical daily clinical performance in these highlighted areas, in order to reduce or even avoid situations that could end up in medico-legal litigations.

Effects of a Financial Transaction Tax - Do Transaction Costs Lower Volatility?: A Literature Review

In this literature review the theorethical framework of Financial transaction taxes and their assumed effect on market volatility is assessed. The empirical evidence from various studies is compared against the theory and a simple empirical review of the Finnish stock market is conducted. The findings implicate that financial transaction taxes can not reduce volatility and their actual effect on markets is dependend by many other factors as well. Some evidence even suggests that transactions taxes may actually raise volatility.

Harmonization of Environmental Costs and Investments Reporting

The objective of this Master’s Thesis is to examine the current state of environmental costs and investments reporting at Stora Enso in the Business Area of Printing and Reading. Differences and the factors causing the differences in environmental costs and investments reporting are examined in order to further harmonize the reporting between the mills. Research method is a case study, which comprises 11 paper mills. Environmental costs are studied from year 2012 and environmental investments from year 2011 or from 2012 depending on the mill. The results show that there are two types of differences such as actual and harmonisable affecting to environmental costs reporting. Actual differences result from factors such as location and technical features of the mill. Harmonisable differences represent differences, which distort the actual differences. Factors that cause harmonisable differences are identification and traceability of environmental costs as well as interpretation of the instructions. Estimation of the environmental share of indirect environmental investments causes differences between the mills in environmental investments reporting, as it has to be done case-by-case judgments. A further research could consider a detailed examination of the data registering process in order to further improve traceability of environmental costs. Furthermore, identification and reporting of potential savings could be studied from environmental point of view as resource efficiency is an increasing interest.

Supply network risks and costs in Finnish project business

This report summarizes the results of the survey HAVERI – Supply network risks in business. The survey was conducted in Finland during the spring and summer of year 2013. The survey is part of a large two-year research project started in June 2012 in Finland (on-going 06/2012–07/2014). The project is launched and financed by TEKES, the Finnish Funding Agency for Technology and Innovation, and executed together with the researchers from Lappeenranta University of Technology and Tampere University of Technology. The overall goal of this on-going research project is to find out the decision-making practices in the project-oriented companies in their purchasing decisions especially in the mechanical engineering and construction industries in Finland. The objective of the survey was to gain cross-sectional data concerning the challenges, risks and cost factors in Finnish project business companies. The results show that Finnish companies rely on their experience and supplier references in their risk management. In general, the understanding of the total cost structure varies among the industries and companies. The main cost factor in risk management was costs before the actual purchase decision. Overall, it seems that the monetary value of the whole project and capability of purchasing personnel are the main influencing factors on risk management activity in project purchasing.

ERP Systems as Investments: Analysing Costs vs. Benefits

An ERP system investment analysis method using a Fuzzy Pay-Off approach for Real Option valuation is examined. It is studied, how the investment can be incrementally adopted and analyzed as a compounding Real Option model. The modeling allows follow-up. IS system development model COCOMO is presented as an example for investment analysis. The thesis presents the usage of Real Options as an alternative for the valuation of an investment. An idea is presented to use a continuous investment follow-up during the investment. This analysis can be performed using Real Options. As a tool for the analysis, the Fuzzy Pay-Off method is presented as an alternative for investment valuation.

Direct costs of asthma in Brazil: a comparison between controlled and uncontrolled asthmatic patients

Asthma is a common chronic illness that imposes a heavy burden on all aspects of the patient's life, including personal and health care cost expenditures. To analyze the direct cost associated to uncontrolled asthma patients, a cross-sectional study was conducted to determine costs related to patients with uncontrolled and controlled asthma. Uncontrolled patient was defined by daytime symptoms more than twice a week or nocturnal symptoms during two consecutive nights or any limitations of activities, or need for relief rescue medication more than twice a week, and an ACQ score less than 2 points. A questionnaire about direct cost stratification in health services, including emergency room visits, hospitalization, ambulatory visits, and asthma medications prescribed, was applied. Ninety asthma patients were enrolled (45 uncontrolled/45 controlled). Uncontrolled asthmatics accounted for higher health care expenditures than controlled patients, US$125.45 and US$15.58, respectively [emergency room visits (US$39.15 vs US$2.70) and hospitalization (US$86.30 vs US$12.88)], per patient over 6 months. The costs with medications in the last month for patients with mild, moderate and severe asthma were US$1.60, 9.60, and 25.00 in the uncontrolled patients, respectively, and US$6.50, 19.00 and 49.00 in the controlled patients. In view of the small proportion of uncontrolled subjects receiving regular maintenance medication (22.2%) and their lack of resources, providing free medication for uncontrolled patients might be a cost-effective strategy for the public health system.

Omnibus accounts to Finnish investors? – An analysis of the costs and benefits that omnibus account structure brings to Finnish account operators and investors

The Finnish Securities Markets are being harmonized to enable better, more reliable and timely settlement of securities. Omnibus accounts are a common practice in the European securities markets. Finland forbids the use of omnibus accounts from its domestic investors. There is a possibility that the omnibus account usage is allowed for Finnish investors in the future. This study aims to build a comprehensive image to Finnish investors and account operators in determining the costs and benefits that the omnibus account structure would have for them. This study uses qualitative research methods. A literature review provides the framework for this study. Different kinds of research articles, regulatory documents, studies performed by European organisations, and Finnish news reportages are used to analyse the costs and benefits of omnibus accounts. The viewpoint is strictly of account operators and investors, and different effects on them are contemplated. The results of the analysis show that there are a number of costs and benefits that investors and account operators must take into consideration regarding omnibus accounts. The costs are related to development of IT-systems so that participants are able to adapt to the new structure and operate according to its needs. Decrease in the holdings’ transparency is a disadvantage of the structure and needs to be assessed precisely to avoid some problems it might bring. Benefits are mostly related to the increased competition in the securities markets as well as to the possible cost reductions of securities settlement. The costs and benefits were analysed according to the study plan of this thesis and as a result, the significance and impact of omnibus accounts to Finnish investors and account operators depends on the competition level and the decisions that all market participants make when determining if the account structure is beneficial for their operations.

A graphic explanation on how a tax on exports neutralizes the Dutch disease without costs to exporters

The adequate way of neutralizing the Dutch disease is the imposition of a variable tax on the export of the commodity that originates the disease. If such tax is equivalent to the "size" of the Dutch disease, it will shifts to the right its supply curve of the commodity in relation to the exchange rate, giving the existing domestic supply and the international demand, the exchange rate will depreciate at the value of the tax, and the equilibrium exchange rate will move from the "current" to the "industrial" equilibrium.

Accounting for Human Rights Violations Risk: Conflict Minerals Mandatory Disclosures under the Dodd Frank Act

This paper examines the equity market response to firms’ disclosure of human rights violation risk with regard to conflict mineral usage as required by Section 1502 of the Dodd-Frank Act (the Act). This paper assesses the aggregate equity market response to regulatory events leading to the passage of the Act, the equity market reaction to voluntary early disclosures and mandatory disclosures of conflict mineral information in Form SD, as well as the determinants of the equity market response. Using a sample of 4,399 US registrants from January 1, 2008 to September 30, 2014, we document a significant negative stock market reaction to the passage of the Act and to conflict minerals disclosures on Form SD. The equity market reaction is more negative and limited to companies that source their minerals from conflict zones, companies with human rights violations, and companies with ambiguous disclosures. Taken together, the results of this study provide an economic justification for companies with poor conflict minerals practices to improve in order to avoid high costs that will arise if firms are forced to disclose human rights abuses. This paper also provides preliminary evidence that Form SD is successful in reducing the governance gap that exposes investors to unnecessary sanction, litigation and reputation risk from firms’ activities in conflict minerals usage.

Clipping from a Town Council meeting at which estimates of the costs of Railway Line no. 1 and Line no. 2 were submitted by the office of Port Dalhousie and Thorold Railway

Clipping from a Town Council meeting at which estimates of the costs of Railway Line no. 1 and Line no. 2 were submitted by the office of Port Dalhousie and Thorold Railway. The estimate was submitted by S.D. Woodruff and George Rykert, president. There is also a disclaimer in which Calvin Phelps claims to have resigned as director of the Port Dalhousie and Thorold Railway when he discovered that the company had no intention to adhere to the original plan for building and running the road, Aug. 1854.