Improving oral healthcare in Scotland with special reference to sustainability and caries prevention

Brett Duane Improving oral healthcare in Scotland with special reference to sustainability and caries prevention University of Turku, Faculty of Medicine, Institute of Dentistry, Community Dentistry, Finnish Doctoral Program in Oral Sciences (FINDOS-Turku), Turku, Finland Annales Universitatis Turkuensis, Sarja- Ser. D, Medica-Odontologica. Painosalama Oy, Turku, Finland, 2015. Dentistry must provide sustainable, evidence-based, and prevention-focused care. In Scotland oral health prevention is delivered through the Childsmile programme, with an increasing use of high concentration fluoride toothpaste (HCFT). Compared with other countries there is little knowledge of xylitol prevention. The UK government has set strict carbon emission limits with which all national health services (NHS) must comply. The purpose of these studies was firstly to describe the Scottish national oral health prevention programme Childsmile (CS), to determine if the additional maternal use of xylitol (CS+X) was more effective at affecting the early colonisation of mutans streptococci (MS) than this programme alone; secondly to analyse trends in the prescribing and management of HCFT by dentists; and thirdly to analyse data from a dental service in order to improve its sustainability. In all, 182 mother/child pairs were selected on the basis of high maternal MS levels. Motherswere randomly allocated to a CS or CS+X group, with both groups receiving Childsmile. Theintervention group consumed xylitol three times a day, from when the child was 3 months until 24 months. Children were examined at age two to assess MS levels. In order to understand patterns of HCFT prescribing, a retrospective secondary data analysis of routine prescribing data for the years 2006-2012 was performed. To understand the sustainability of dental services, carbon accounting combined a top-down approach and a process analysis approach, followed by the use of Pollard’s decision model (used in other healthcare areas) to analyse and support sustainable service reconfiguration. Of the CS children, 17% were colonised with MS, compared with 5% of the CS+X group. This difference was not statistically significant (P=0.1744). The cost of HCFT prescribing increased fourteen-fold over five years, with 4% of dentists prescribing 70% of the total product. Travel (45%), procurement (36%) and building energy (18%) all contributed to the 1800 tonnes of carbon emissions produced by the service, around 4% of total NHS emissions. Using the analytical model, clinic utilisation rates improved by 56% and patient travel halved significantly reducing carbon emissions. It can be concluded that the Childsmile programme was effective in reducing the risk for MS transmission. HCFT is increasing in Scotland and needs to be managed. Dentistry has similar carbon emissions proportionally as the overall NHS, and the use of an analytic tool can be useful in helping identify these emissions. Key words: Sustainability, carbon emissions, xylitol, mutans streptococci, fluoride toothpaste, caries prevention.

Utilization of recycled mineral wool as filler in wood plastic composites

The impact of a recycled mineral wool filler on the various properties of wood plastic composites was studied and the critical factors affecting the formation of the properties were determined. An estimation of the volume of mineral wool fiber waste generated in the European Union between the years 2010-2020 was presented. Furthermore, the effect of fiber pre-treatment on the properties of the wood plastic composites were studied, and the environmental performance of a wood plastic composite containing recycled mineral fibers was assessed. The results showed that the volumes of construction and demolition waste and new mineral wool produced in the European Union are growing annually, and therefore also the volumes of recycled mineral wool waste generated are increasing. The study showed that the addition of recycled mineral wool into composites can enhance some of the mechanical properties and increase the moisture resistance properties of the composites notably. Recycled mineral wool as a filler in wood plastic composites can also improve the fire resistance properties of composites, but it does not protect the polymer matrix from pyrolysis. Fiber pre-treatment with silane solution improved some of the mechanical properties, but generally the use of maleated polypropylene as the coupling agent led to better mechanical and moisture resistance properties. The environmental performance of recycled mineral wool as the filler in wood plastic composites was superior compared to glass fibers. According to the findings, recycled mineral wool fibers can provide a technically and environmentally viable alternative to the traditional inorganic filler materials used in wood plastic composites.

Tuottavuuden, vaikuttavuuden ja kustannusvaikuttavuuden arviointi alueellisesti integroiduissa sosiaali- ja terveyspalveluissa – palvelujen käyttöön perustuva malli ja esimerkkejä

Yli puolet kuntien vuosibudjeteista kuluu sosiaali- ja terveyspalveluihin. Jatkossa väestö ikääntyy ja huoltosuhteen muutos tulee niukentamaan kuntien resursseja ja lisäämään palvelujen tarvetta. Näin ollen vaikuttavien ja kustannustehokkaiden ratkaisumallien luominen on ensiarvoisen tärkeää. Tutkimuksen tavoitteena on rakentaa malli, jota voidaan hyödyntää tuottavuuden, vaikuttavuuden ja kustannusvaikuttavuuden jatkuvassa seurannassa alueellisissa sosiaali- ja terveyspalveluissa ja testata mallia esimerkkitapauksilla. Pääpaino on vaikuttavuudessa ja kustannusvaikuttavuudessa. Aiemman tutkimuksen perusteella tuottavuuden, vaikuttavuuden ja kustannusvaikuttavuuden mittaamiseen on useita lähestymistapoja. Tässä tutkimuksessa tuottavuutta arvioidaan panosten ja tuotosten suhteella, vaikuttavuutta palvelujen käytöllä ja kustannusvaikuttavuutta palvelujen käytön kustannuksilla. Kirjallisuudesta nousee esille selkeä tarve yli perinteisten organisaatiorajojen menevälle jatkuvalle vaikuttavuuden seurannalle. Aikaisempi tutkimus kattaa kertaluontoisia selvityksiä, joissa usein mittarit ovat operatiivisella tasolla, toimialasidonnaisia tai vaikeasti mitattavissa. Tutkimus on suunnittelutiedettä. Tutkimuksen lopputuloksena syntyy sosiaali- ja terveyspalvelujen käyttömalli (sote-palvelujen käyttömalli), jota varten toteutetaan tietokanta ja raportointikerros. Sote-palvelujen käyttömallia testataan tässä tutkimuksessa kolmella eri organisaatioyksiköllä ja asiakasryhmällä, jotka ovat strategisesti merkittäviä tutkittavalle organisaatiolle ja asiakasryhmiin on kohdennettu selkeä kehittämistoimenpide (kuntoutukseen panostaminen ja vammaisten sekä vanhusten laitoshoidon purku). Sote-palvelujen käyttömalli tuottaa tietoa kehittämistoimenpiteiden tuottavuudesta, vaikuttavuudesta ja kustannusvaikuttavuudesta. Sote-palvelujen käyttömallin todetaan soveltuvan tutkittavaan organisaatioon ja sote-palvelujen käyttömalli on sielläjatkuvassa käytössä. Sote-palvelujen käyttömalli on siirrettävissä myös muihin soteorganisaatioihin ja laajennettavissa myös muihin sosiaali- ja terveyspalveluihin ja niitä lähellä oleviin palveluihin.

Comparing the alternative utilization method for coconut in Nzema, Ghana

There are many opportunities to utilise coconut in Nzema to support farmers. Coconut oil that is mainly used for food preparation in Nzema can be utilized as fuel to support overcoming of the energy crisis in the Ghana. Coconut oil in Nzema is not used in both transportation and electricity generation. A few of the waste husk and shell are mainly used as fuel in homes for heating but greater amount is left to rot or burn the coconut plantation. In addition, some portion of the granulated coconut kernel is sometime used as feed for piggery feed and the rest of the granulated kernel are left as waste on the oil processing site. In this thesis, the author identified alternative utilization of cocoanut, for instance the use of coconut husk and shell for charcoal production, and the use of coconut trunks as construction materials. It is envisaged that exploring these alternatives will not only reduce carbon emission in the country but will also contribute significantly to the sustainability of the local agro-industry.

Utilization of multi-branding in business to business markets

Case company utilizes multi-branding strategy (or house of brands strategy) in its product portfolio. In practice the company has multiple brands – one main brand and four acquired brands – which all utilize one single product platform. The objective of this research is to analyze case company’s multi-branding strategy and its benefits and challenges. Moreover, the purpose is to clarify that how could a company in B2B markets utilize multi-branding strategy more efficiently and profitably. The theoretical part of this thesis consists of aspects of branding strategies; different brand name architectures, benefits and challenges of different strategies and different ways of utilize branding strategies in mergers and acquisitions. The empirical part, on the other hand, includes the description of the case company’s branding strategy and the employees’ perspective on the benefits and challenges of multi-branding strategy, and how to utilize it more efficiently and profitably. This study shows, that the major benefits of utilizing multi-branding are lower production costs, ability to reach wider market coverage, possibility to utilize common sales tools, synergies in R&D and shared resources. On the other hand, the major challenges are lack of product differentiation, internal competition, branding issues in production and deliveries, pricing issues and conflicts, and compromises in product compatibility and suitability. Based on the results, several ways to utilize multi-branding strategy more efficiently and profitably were found; by putting more effort on brand image and product differentiation, by having more co-operation among the brands and by focusing on more precise customer and market segmentation.

Utilization of Statistical Methods for Management in the Forest Industry

The strongest wish of the customer concerning chemical pulp features is consistent, uniform quality. Variation may be controlled and reduced by using statistical methods. However, studies addressing the application and benefits of statistical methods in forest product sector are scarce. Thus, the customer wish is the root cause of the motivation behind this dissertation. The research problem addressed by this dissertation is that companies in the chemical forest product sector require new knowledge for improving their utilization of statistical methods. To gain this new knowledge, the research problem is studied from five complementary viewpoints – challenges and success factors, organizational learning, problem solving, economic benefit, and statistical methods as management tools. The five research questions generated on the basis of these viewpoints are answered in four research papers, which are case studies based on empirical data collection. This research as a whole complements the literature dealing with the use of statistical methods in the forest products industry. Practical examples of the application of statistical process control, case-based reasoning, the cross-industry standard process for data mining, and performance measurement methods in the context of chemical forest products manufacturing are brought to the public knowledge of the scientific community. The benefit of the application of these methods is estimated or demonstrated. The purpose of this dissertation is to find pragmatic ideas for companies in the chemical forest product sector in order for them to improve their utilization of statistical methods. The main practical implications of this doctoral dissertation can be summarized in four points: 1. It is beneficial to reduce variation in chemical forest product manufacturing processes 2. Statistical tools can be used to reduce this variation 3. Problem-solving in chemical forest product manufacturing processes can be intensified through the use of statistical methods 4. There are certain success factors and challenges that need to be addressed when implementing statistical methods

Governance of Healthcare Data: International Standards and Recommendations

In the global phenomenon, the aging population becomes a critical issue. Data and information concerning elderly citizens are increasing and are not well organized. In addition, these unstructured data and information cause the problems for decision makers. Since we live in a digital world, Information Technology is considered to be a tool in order to solve problems. Data, information, and knowledge are crucial components to facilitate success in IT service system. Therefore, it is necessary to study how to organize or to govern data from various sources related elderly citizens. The research is conducted due to the fact that there is no internationally accepted holistic framework for governance of data. The research limits the scope to study on the healthcare domain; however, the results can be applied to the other areas. The research starts with an ongoing research of Dahlberg and Nokkala (2015) as a theory. It explains the classification of existing data sources and their characteristics with the focus on managerial perspectives. Then the studies of existing frameworks at international and national level organizations have been performed to show the current frameworks, which have been used and are useful in compiling data on elderly citizens. The international organizations in this research are selected based on their reputations and the reliability to obtain information. The selected countries at national level provide different point of views between two countries. Australia is a forerunner in IT governance while Thailand is the country which the author has familiar knowledge of the current situation. Considered the discussions of frameworks at international and national organizations level illustrate the main characteristics of each framework. At international organization level gives precedence to the interoperability of exchanging data and information between different parties. Whereas at national level shows the importance of the acknowledgement of using frameworks throughout the country in order to make the frameworks to be effective. After the studies of both international and national organization levels, the thesis shows the summarized tables to answer the fitness to the proposed framework by Dahlberg and Nokkala whether the framework help to consolidate data from various sources with different formats, hierarchies, structures, velocities, and other attributes of data storages. In addition, suggestions and recommendations will be proposed for the future research.

Possibilities and challenges in utilization of information provided by Industrial Internet applications

Global digitalization has affected also industrial sector. A trend called Industrial Internet has been present for some years and established relatively steady position in businesses. Industrial Internet is also referred with the terminology Industry 4.0 and in consumer businesses IoT (Internet of Things). Eventually, trend consists of many traditionally proven technologies and concepts, such as condition monitoring, remote services, predictive maintenance and Internet customer portals. All these technologies and information related to them are estimated to change the rules of business in industrial sector. This may result even a new industrial revolution. This research has its focus on Industrial Internet products, services and applications. The study analyses four case companies and their digital service offerings. According to this analysis the comparison of these services is done to find out if there is still space for companies to gain competitive advantage through differentiation with these state of the art solutions. One of the case companies, Case Company Ltd., is working as a primary case company and a subscriber of this particular research. The research and results are analyzed primarily from this company’s perspective and need. In empirical part, the research clarifies how Case Company Ltd. has allocated its development resources through last five years. These allocations in certain categories are then compared to other case companies’ current customer offering and conclusions are made how the approach of different companies differ from each other. Existing theoretical knowledge of Industrial Internet is about to find its shape. In this research we take a look how the case company analysis and findings correlate with the existing knowledge and literature of the topic.

Corporate Entrepreneurship in Healthcare Organizations: An explorative study of employees’ corporate entrepreneurial behavior, job satisfaction and turnover intention

The Finnish healthcare industry is currently facing significant challenges due to economic crises, aging population and major structural reforms, which have resulted in decreased job satisfaction and increased levels of turnover. This proposes that healthcare organizations need to come up with new, creative means to tackle these issues. Several researchers have argued that corporate entrepreneurship may be the necessary means to achieve this. As previous research has mainly focused on examining this concept from organizational perspective, this study looks at how it occurs on the level of individual employees. The purpose of this study is to examine how corporate entrepreneurship is manifested in individual behavior, and how this type of behavior is associated with the individual’s job satisfaction and turnover intention. Additionally, this study will examine the differences in corporate entrepreneurial behavior between private and public sector organizations, as previous research suggests that these two may be characterized differently. Data was collected with the help of a literature review as well as a survey study, which was sent out to a number of employees of four different healthcare organizations, out of which three were public and one was a private sector organization. Six distinct behavioral characteristics were recognized in previous research, which make up the measure for corporate entrepreneurial behavior. Principal components were formed from the different areas of the survey (corporate entrepreneurial behavior, job satisfaction, turnover intention), after which the association of these components were examined with linear regression analysis, which proved that corporate entrepreneurial behavior is positively correlated with both job satisfaction and intention to leave the organization. Differences between sectors were analyzed with analysis of variance and cross tabulation analysis, but neither of these suggested that any significant differences would occur. These results suggest that employees who behave entrepreneurially tend to be more satisfied with their jobs, but also consider leaving their current organizations more often than others. This may be due to the fact that healthcare organizations are not fertile for entrepreneurial behavior, which will drive entrepreneurial individuals looking for employers who may be more supportive of this type of behavior. With growing levels of dissatisfaction as well as little room for entrepreneurial behavior, the studied organizations may actually be in the process of losing those employees who have the ability and desire to behave in such manner, and who could very well be those who will eventually come up with solutions for the major challenges that these organizations are facing.

Healthcare Services In CloudComputing

The Thesis title” Healthcare services in cloud computing” discusses the healthcare services available in the new converging technology called cloud computing. This computing technology had craved its path in the desirable market field healthcare. Healthcare is an extensive and a massive mission of maintenance and providing a complete treatment to the person suffering from ailments. In the olden days well equipped healthcare surveillance is not accessible to all communities of people due to several reasons like, geographical locations, equipment cost, and infrastructure, and skilled medical practitioners, now due to the advancement of the medicine in cloud technology has reached some of its barriers making it more viable to all the people (communities) with all the robust technologies and techniques. This study will give an overview of the healthcare transformation of different approaches of cloud computing over information technology and its strategic usage. Further enhancing better healthcare to ensure scalable, compatible functions supporting the well-being, this study also considers the techniques of cloud computing and its application, advancement in healthcare.

Timing of di-ammonium phosphate addition to fermenting chardonnay must : effect on nitrogen utilization, ethyl-carbamate formation, and CAR1 expression by yeast /

The maximum amount of ethyl carbamate (EC), a known animal carcinogen produced by the reaction of urea and ethanol, allowed in alcoholic beverages is regulated by legislation in many countries. Wine yeast produce urea by the metabolism of arginine, the predominant assimilable amino acid in must. This action is due to arginase (encoded by CARl). Regulation of CARl, and other genes in this pathway, is often attributed to a well-documented phenomenon known as nitrogen catabolite repression. The effect of the timing of di-ammonium phosphate (DAP) additions on the nitrogen utilization, regulation of CARl, and EC production was investigated. A correlation was found between the timing of DAP addition and the utilization of nitrogen. When DAP was added earlier in the fermentations, less amino nitrogen and more ammonia nitrogen was sequestered from the media by the cells. It was also seen that early DAP addition led to more total nitrogen being used, with a maximal difference of ~25% between fermentations where no DAP was added versus addition at the start of the fermentation. The effect of the timing ofDAP addition on the expression of CARJ during fermentation was analyzed via northern transfer and the relative levels of CARl expression were determined. The trends in expression can be correlated to the nitrogen data and be used to partially explain differences in EC formation between the treatments. EC was quantified at the end of fermentation by GC/MS. In Montrachet yeast, a significant positive correlation was found between the timing of DAP addition, from early to late, and the final EC concentration m the wine (r = 0.9226). In one of the fermentations, EC levels of 30.5 ppb was foimd when DAP was added at the onset of fermentation. A twofold increase (69.5 ppb) was observed when DAP was added after 75% of the sugars were metabolized. When no DAP was added, the ethyl carbamate levels are comparable at a value of 38 ppb. In contrast, the timing of DAP additions do not affect the level EC produced by the yeast ECU 18 in this manner. The study of additional yeast strains shows that the effect of DAP addition to fermentations is strain dependent. Our results reveal the potential importance of the timing of DAP addition to grape must with respect to EC production, and the regulatory effect of DAP additions on the expression of genes in the pathway for arginine metabolism in certain wine yeast strains.

Effects of intracerebroventricular bombesin administration on local cerebral glucose utilization in the restrained and unrestrained rat

Intracerebroventricular (ICV) administration of bombesin (BN) induces a syndrome characterized by stereotypic locomotion and grooming, hyperactivity and sleep elimination, hyperglycemia and hypothermia, hyperhemodynamics, feeding inhibition, and gastrointestinal function changes. Mammalian BN-like peptides (MBNs), e.g. gastrin-releasing peptide (GRP), Neuromedin C (NMC), and Neuromedin B (NMB), have been detected in the central nervous system. Radio-labeled BN binds to specific sites in discrete cerebral regions. Two specific BN receptor subtypes (GRP receptor and NMB receptor) have been identified in numerous brain regions. The quantitative 2-[14C]deoxyglucose ([14C]20G) autoradiographic method was used to map local cerebral glucose utilization (LCGU) in the rat brain following ICV injection of BN (vehicle, BN O.1Jlg, O.5Jlg). At each dose, experiments were conducted in freely moving or restrained conditions to determine whether alterations in cerebral function were the result of BN central administration, or were the result of BN-induced motor stereotypy. The anteroventral thalamic nucleus (AV) (p=O.029), especially its ventrolateral portion (AVVL) (p

Sperm utilization patterns in Gryllus integer (orthoptera: gryllidae

Sperm competition is the competition for fertilizations between ejaculates, within a female, following multiple mating. There are four sperm utilization or precedence patterns: first male precedence, where the first male to mate fertilizes most of the eggs laid by a female; last male precedence, where the last male to mate fertilizes most of the eggs laid by a female; "all-or-none" pattern, where sperm from either male fertilizes all the eggs laid by a female but which male's sperm that is used is random; or sperm mixing, where sperm from each male is used equally in fertilizing eggs laid by a female. Intermediate utilization patterns are also possible. Sperm competition occurs in a wide variety of insect species as well as other animals. This study was undertaken to study sperm competition in the field cricket, Gryllus integer. Four experiments were conducted: a radiation and sterilization experiment, a diapause experiment, and 2 competition experiments. It was found that 7,000 rad of gamma radiation sterilized adult ~ integer males. There was no diapause in the laboratory in ~ integer eggs. In the first competition experiment, three groups of females were used: females mated with a normal male, then with a second normal male (NN group); females mated with a normal male, and then with a sterile male (NR group); and females mated with a sterile male, and then with a normal male (RN group). The results obtained from this experiment showed that the mean proportion of eggs hatched was significantly different between 3 groups of females, with the proportion hatched much greater in the NN group than in either the NR or RN groups. The pattern for the proportion of eggs hatched following a double mating most closely resembled a pattern expected if sperm mixing is occurring. Results obtained in the replicate competition experiment showed that the mean proportion of eggs hatched for the females in the NR group was significantly lower than the proportion hatched in the other two groups. This also supports a model of sperm mixing as a precedence pattern. Values calculated following Boorman and Parker (1976), for the proportion of eggs fertilized by the second male to mate following a double mating, were 0.57 in competition experiment 1 and 0.62 in the replicate. These values indicate that sperm mixing occurs in~ integer.

The versatility and utilization of phosphorus based compounds in classic carbon-carbon bond forming and esterification reactions

The phosphonium salt room temperature ionic liquid tetradecyltrihexylphosphonium chloride (THPC) has been employed as an efficient reusable media for the palladium catalyzed Suzuki cross-coupling reaction of aryl halides, including aryl chlorides, under mild conditions. The cross-coupling reactions were found to proceed in THPC containing small amounts ofwater and toluene (single phase) using potassium phosphate and 1% Pd2(dba)3'CHCI3. Variously substituted iodobenzenes, including electron rich derivatives, reacted efficiently in THPC with a variety of arylboronic acids and were all complete within 1 hour at 50°C. The corresponding aryl bromides also reacted under these conditions with the addition of a catalytic amount of triphenylphosphine that allowed for complete conversion and high isolated yields. The reactions involving aryl chlorides were considerably slower, although the addition of triphenylphosphine and heating at 70°C allowed high conversion of electron deficient derivatives. Addition of water and hexane to the reaction products results in a triphasic system, from which the catalyst was then recycled by removing the top (hexanes) and bottom (aqueous) layers and adding the reagents to the ionic liquid which was heated again at 50°C; resulting in complete turnover of iodobenzene. Repetition of this procedure gave the biphenyl product in 82-97% yield (repeated five times) for both the initial and recycled reaction sequences. IL ESTERIFICATIONREACTION A new class oftrialkylphosphorane has been prepared through reaction of a trialkylphosphine with 2-chlorodimethylmalonate in the presence oftriethylamine. These new reagents promote the condensation reaction of carboxylic acids with alcohols to provide esters along with trialkylphosphine oxide and dimethylmalonate. The condensation reaction of chiral secondary alcohols can be controlled to give either high levels of inversion or retention through a subtle interplay involving basicity of the reaction media, solvent, and tuning the electronic and steric nature of the carboxylic acid and stenc nature of the phosphorane employed. A coherent mechanism is postulated to explain these observations involving reaction via an initial acyloxyphosphonium ion.