Characterization of clinical and electrocardiographic findings in a youth population

Resting 12-lead electrocardiogram (ECG) has been employed in the evaluation of young asymptomatic subjects to detect pre-existing heart diseases. Although the incorporation of routine ECG remains controversial, there is increasing evidence that cardiomyopathies and ion channelopathies show ECG changes as the initial manifestation. The causes of sudden cardiac death in young people show a significant geographical variation. We aim to determine the prevalence and spectrum of ECG findings in a youth population. Methodology: From May 2010 to April 2013, a total of 976 young secondary school students (mean age, 14 years; range, 13-15) underwent voluntary medical screening that included a resting 12-lead ECG and structured clinical survey. Subjects with abnormal ECG findings were classified into two groups: major ECG findings group, which fulfilled a pre-specified checklist to screen for principal structural and electrical cardiopathies, and minor ECG findings group showing other ECG changes. The major ECG findings group was referred for secondary diagnostic tests at a tertiary institution. Results: Of the 976 subjects screened, 252 (25.82%; CI95%, 23.17-28.66) had ECG findings. Of note, 17 (1.74%) had major findings and 235 (24.08%) had minor findings on ECG. The prevalence of cardiovascular pathology within the major ECG findings group was 35.29%. The prevalence of ECG abnormalities was significantly higher in males than in females (29% vs 20.9%, P<0.01). Conclusions: The prevalence of ECG findings in a youth population was 25.82%. There were significant gender differences. The inclusion of universal ECG screening, in addition to medical history, may increase the sensitivity of a cardiovascular screening program. Knowledge of the spectrum and prevalence of ECG findings and disease conditions would be pivotal in designing customized screening programs

Apolipoprotein E and Recovery from Traumatic Brain Injury

The outcome from traumatic brain injury (TBI) is variable and only partly explained by known prognostic factors. This is especially true for predicting long-term outcome. Genetic factors may influence the brain`s susceptibility to injury or capacity for repair and regeneration. To examine the association of apolipoproteinE (apoE) genotype with long-term outcome, hippocampal volumes and general brain atrophy, we determined the apoE genotype from 61 TBI patients who had been injured over on average 31 years earlier. The long-term outcome was evaluated with repeated neuropsychological testing and by applying various measures of everyday functioning and quality of life. Magnetic resonance imaging (MRI) based volumetric analyses of the hippocampus and lateral ventricles were performed. In the prospective study, the purpose was to examine the association between apoE genotype and visibility of traumatic brain lesions during the first year after TBI and the ability of apoE genotype, the Glasgow Coma Score (GCS), MRI findings and duration of posttraumatic amnesia (PTA) to predict the one-year outcome. Thirty-three patients with TBI were studied and the outcome was evaluated with the Head Injury Symptom Checklist (HISC) and the Glasgow Outcome Scale extended version (GOS-E) scores one year after the injury. MRI and apoE genotyping were carried out. After three decades, neither hippocampal nor lateral ventricle volumes differed significantly in those patients with the apoE ε4 allele vs those without this allele, but the TBI patients with the apoE ε4 allele showed significantly poorer general cognitive level than those without this allele. This decline was wholly accounted for by a subgroup of patients who had developed incident or clinical dementia. In the prospective study the apoE genotype was not associated with visible MRI changes or outcome. The duration of PTA and acute MRI were the best predictors of one-year outcome in TBI. A portion of the TBI patients with the apoE ε4 allele seem to be at risk of long-term cognitive decline. This association may involve mechanisms other than those responsible for the development of brain atrophy. The early MRI and PTA have an important role in assessing the injury severity and prognosis.

Sähköinen tarkastuslista rakennusteollisuuden laadunvalvonnan tukena

Rakennusteollisuus on tunnettu useita muita aloja hitaammasta uuden teknologian käyttöönotosta. Yleisesti käytössä on hyvin perinteinen paperia ja kynää hyödyntävä tiedontallennuskäytäntö. Paperin käytössä tiedon tallennusvälineenä on useita ongelmia kuten säilytettävyys ja hallittavuus, joista päästään eroon siirtymällä sähköiseen tiedon tallennukseen. Laadun varmistamiseksi voidaan käyttää tarkastuslistoja, jotka toimivat tarkastuksien suorittajan muistin tukena. Muutettaessa tarkastuslista sähköiseen muotoon, voidaan välttyä paperisen tarkastuslistan ongelmilta, kuten käsialan tunnistamiselta ja merkintätapojen vaihtelevuudelta. Tässä diplomityössä käsitellään rakennusteollisuuden laadunhallinnan nykytilaa sekä sähköisen tarkastuslistan käyttöä rakennusteollisuuden laadunvalvonnassa. Lisäksi esitellään prototyyppi sähköisestä tarkastuslistasta osana laadunvalvontaa. Sähköinen tarkastuslista toteutetaan dynaamisesti niin, että tarkastuslistojen pohjalta on mahdollista luoda käyttöliittymä kyseessä olevan listan mukaisesti päätelaitteelle. Sähköisen tarkastuslistan prototyyppi on toteutettu WWW-sovelluspalveluna (World Wide Web), joka mahdollistaa useiden erilaisten päätelaitteiden hyödyntämisen.

Informações essenciais para a caracterização de um sistema de análise em fluxo

Essential aspects for characterization of a flow-based analytical procedure or system are discussed in order to permit the composition of a checklist that will lead to a protocol for reporting results and systems in flow analysis. Aspects more related to chromatographic procedures are not considered. The intent is to present normalized proposals in the field of flow analysis for practitioners and developers.

Predictors and consequences of adherence to the treatment of pediatric patients with attention-deficit/hyperactivity disorder in Central Europe and East Asia.

PURPOSE: To assess baseline predictors and consequences of medication non-adherence in the treatment of pediatric patients with attention-deficit/hyperactivity disorder (ADHD) from Central Europe and East Asia. PATIENTS AND METHODS: Data for this post-hoc analysis were taken from a 1-year prospective, observational study that included a total of 1,068 newly-diagnosed pediatric patients with ADHD symptoms from Central Europe and East Asia. Medication adherence during the week prior to each visit was assessed by treating physicians using a 5-point Likert scale, and then dichotomized into either adherent or non-adherent. Clinical severity was measured by the Clinical Global Impressions-ADHD-Severity (CGI-ADHD) scale and the Child Symptom Inventory-4 (CSI-4) Checklist. Health-Related Quality of Life (HRQoL) was measured using the Child Health and Illness Profile-Child Edition (CHIP-CE). Regression analyses were used to assess baseline predictors of overall adherence during follow-up, and the impact of time-varying adherence on subsequent outcomes: response (defined as a decrease of at least 1 point in CGI), changes in CGI-ADHD, CSI-4, and the five dimensions of CHIP-CE. RESULTS: Of the 860 patients analyzed, 64.5% (71.6% in Central Europe and 55.5% in East Asia) were rated as adherent and 35.5% as non-adherent during follow-up. Being from East Asia was found to be a strong predictor of non-adherence. In East Asia, a family history of ADHD and parental emotional distress were associated with non-adherence, while having no other children living at home was associated with non-adherence in Central Europe as well as in the overall sample. Non-adherence was associated with poorer response and less improvement on CGI-ADHD and CSI-4, but not on CHIP-CE. CONCLUSION: Non-adherence to medication is common in the treatment of ADHD, particularly in East Asia. Non-adherence was associated with poorer response and less improvement in clinical severity. A limitation of this study is that medication adherence was assessed by the treating clinician using a single item question.

Kunnan kiinteistöjen energiansäästöpotentiaali

Tämän diplomityön tarkoitus oli selvittää kolmen suomalaisen HINKU-kunnan, Mynämäen, Padasjoen ja Kuhmoisten kiinteistöjen energiansäästöpotentiaali. Työssä käytiin aluksi läpi kunnan kiinteistöjen perustiedot sekä kulutuslukemat, jonka jälkeen kiinteistöihin tutustuttiin kiinteistönhoitajan avustuksella. Tämän jälkeen pyrittiin identifioimaan säästötoimet muutamien yritysten sekä vuorovaikutteisesti kiinteistönhoitajien kanssa. Säästötoimien vaikuttavuuden arvioinnissa hyödynnettiin sähkön ja lämmön tuntimittarointia. Lopuksi tulokset esiteltiin kuntien johdolle. Säästöpotentiaalia löytyi lähes jokaiselta osa-alueelta. Perinteisesti suurin säästöpotentiaali on löytynyt ilmanvaihdosta, mutta tämän työn puitteissa suurimmat säästöt löydettiin valaistuksesta. Etenkin LED-tekniikan kehittyminen on muuttamassa valaistuksen tulevaisuutta. Yksittäisten kohteiden suurimmat säästömahdollisuudet olivat vanhojen öljylämmitysten muuttamisessa maa- ja kaukolämpöön. Myös ilmanvaihdosta löytyi hyvin merkittävä potentiaali useassa kohteessa. Mynämäellä säästöpotentiaalia löytyi kaikkiaan noin 17 % kunnan energialaskusta. Padasjoella ja Kuhmoisissa vastaava luku oli noin 12–13 % kummassakin. Työn laajentaminen muihin kuntiin ei pääosin ole suoraviivaista, koska kuntien rakennuskanta poikkeaa toisistaan ja lisäksi kaikki rakennukset ovat yksilöllisiä. Työ pystyi kuitenkin tuottamaan kohdekunnissa erilaista havaintoaineistoa ja toimenpide-ehdotuksia, jotka toimivat muissa kunnissa herättelijöinä, ideoiden antajina ja tarkistuslistana siihen, miten asiat on hoidettu ja minkälaisiin toimenpiteisiin tulisi ryhtyä.

Nollapistekiinnittimen hyödyntäminen työkalun valmistuksessa ja muovausprosessissa

Tämä diplomityö tehtiin Lappeenrannan teknillisen yliopiston konetekniikan osastolle. Työn tavoitteena oli kartoittaa nollapistekiinnittimien tyyppejä ja toimintaperiaatteita sekä luoda muistilista liittyen nollapistekiinnittimen käyttöönottoon kiinnitysratkaisuna. Nollapistekiinnitin on konepajatekniikan kappaleenkiinnitin, joka tarjoaa tarkan paikoituksen, nopean asetusajan ja yksinkertaisen kappaleenvaihdon. Työssä tutkitaan nollapistekiinnittimien ominaisuuksia ja käyttökohteita, esitellään erityyppisiä nollapistekiinnittimiä ja vertaillaan niitä perinteisiin kiinnitysmenetelmiin. Työn kokeellisen osuuden tavoite oli tutkia nollapistekiinnittimen ominaisuuksia ja toimintaa ja pohtia mahdollisuuksia muovaustyökalun valmistuksessa ja kiinnittämisessä muovauspuristimeen. Kokeet tehtiin LTY:n konepajatekniikan laboratoriossa kesä- ja heinäkuussa 2010.

Simulação in Situ, uma Metodologia de Treinamento Multidisciplinar para Identificar Oportunidades de Melhoria na Segurança do Paciente em uma Unidade de Alto Risco

Introdução A simulação é uma metodologia usada para substituir ou amplificar experiências reais por experiências guiadas que evocam ou replicam aspectos do mundo real de maneira interativa. A simulação in situ leva essa técnica diretamente aos locais onde ocorrem atendimentos, com a própria equipe de saúde atuando em seu ambiente de trabalho em cenário simulado. Objetivo Descrever experiência piloto de simulação in situ realizada em unidade de pronto atendimento, destacando oportunidades de avaliação de sistema de atendimento, trabalho em equipe e detecção de ameaças latentes à segurança (ALS). Métodos Estudo aplicado na Unidade Ibirapuera do Hospital Israelita Albert Einstein e realizado pelo Centro de Simulação Realística Albert Einstein. Foi apresentado cenário de paciente de 45 anos com síndrome coronariana aguda que evolui para parada cardiorrespiratória. Simulação híbrida de 30 minutos com uso de ator e simulador de alta fidelidade (SimMan 3G®).Utilizado checklist e filmagem para avaliar habilidades e atitudes, usados em debriefing estruturado com uma hora de duração. Resultados A experiência proporcionou avaliação técnica, comportamental e sistemas. Detectou quatro ALS e permitiu reflexão guiada sobre trabalho em equipe. Conclusão Este piloto contribuiu para o alcance dos objetivos propostos com o cenário e demonstrou oportunidades de treinamento e melhoria. A simulação in situ pode ser usada no futuro sistematicamente para treinamento contínuo de equipes, visando à melhoria da qualidade de atendimento e à segurança do paciente.

Avaliação dos riscos de acidentes em atividades de poda de árvores na arborização urbana do distrito federal

Esta pesquisa teve por objetivo avaliar os riscos de acidentes em atividades de poda de árvores na arborização urbana do Distrito Federal. A coleta de dados foi feita com a aplicação de um questionário em forma de entrevista individual. Responderam ao questionário 94% dos funcionários, sendo 92% do total dos operadores de motosserra e 95% do total de auxiliares. Além disso, foi realizada uma avaliação qualitativa do risco de acidentes nas máquinas e equipamentos de poda e nos veículos de transporte dos trabalhadores, com a aplicação de um "checklist". De acordo com os resultados, para a maioria dos operadores de motosserra (78,3%), os equipamentos de proteção individual eram importantes e já os protegeram contra acidentes. Com relação ao índice de acidentes, 56,5% dos operadores de motosserra afirmaram que sofreram algum tipo de acidente na empresa, e 65,2% desses já presenciaram acidente no trabalho. Entre os auxiliares, 87,2% responderam que o uso de equipamentos de proteção individual já evitou a ocorrência de acidentes no trabalho, 30,8% disseram que sofreram acidente decorrente da atividade de poda e 48,7% presenciaram acidentes no trabalho. Quanto aos equipamentos avaliados, todas as motosserras estavam em bom estado de conservação e possuíam sistema de segurança adequado. A maioria dos baús adaptados para o transporte dos trabalhadores sobre os caminhões apresentava má distribuição e insuficiência de janelas de ventilação. Os assentos tinham pouca inclinação para a coluna, e os cintos de segurança de duas pontas estavam mal fixados. Para um melhor desenvolvimento do trabalho, recomendam-se melhorar e facilitar o fornecimento dos equipamentos de proteção individual aos trabalhadores, oferecer cursos de aperfeiçoamento de técnicas de segurança no trabalho e treinamento aos recém-admitidos e melhorar o veículo de transporte dos trabalhadores, tanto no quesito segurança quanto no quesito conforto.

Nurse-led interpersonal counselling for depressive symptoms in patients with myocardial infarction

The broad interest of this intervention study is in two worldwide remarkable diseases, myocardial infarction and depression. The purpose of the 18-month follow-up study was to evaluate the outcomes of interpersonal counselling implemented by a psychiatric nurse, and to examine the recovery experienced by the patients after myocardial infarction. The interpersonal counseling consisted of a short-term (max 6 sessions) depression-focused intervention modified for myocardial infarction patients. The main principle of interpersonal counselling is that depressive symptoms relate to interpersonal relations. The measured outcomes of the intervention consisted of changes in depressive symptoms and distress, health-related quality of life and the use of health care services. The data consisted of 103 patients with acute myocardial infarction and with sufficient knowledge of Finnish language, and they were randomized into intervention group (n=51) and control group (n=52) with standard care. Depressive symptoms were measured using Beck Depression Inventory, and distress using Symptom Checklist-25. The instrument to measure health-related quality of life was EuroQol-5 Dimensions. All instruments were used at three measurements: in hospital, at 6 months and at 18 months after hospital discharge. The Use of Health Care Services questionnaire was used during the 6- and 18-month period after hospital discharge. In addition, satisfaction with the intervention and with information received from the health-care professional was evaluated during the follow-up. To examine recovery, the patients kept diaries during a 6-month period and they were interviewed at 18 months after myocardial infarction. The number of patients with depressive symptoms decreased significantly more in the intervention group compared with the control group during 18 months of follow-up. Distress decreased significantly more among patients under 60 years in the intervention group than in the control group, but the difference was not significant between the groups. No differences in the changes of health-related quality of life were found between the groups during follow-up. However, in the group of patients under 60 years, the improvement of health-related quality of life in the intervention was significantly better in the intervention group compared with the control group during the follow-up. During the follow-up period, there was even a decline in the use of somatic specialized health care services in the intervention group and among intervention patients who had no other long-term disease. Considering recovery experienced by the patients, main categories including many supporting and inhibiting factors and subcategories were identified: clinical and physical, psychological, social, functional and professional category. No differences between the groups were found in satisfaction with information received from the professionals. The brief and easy-to-learn intervention, with which the patients were satisfied, seems to decrease depressive symptoms after myocardial infarction. Interpersonal counselling seems to be beneficial especially with younger patients. These results justify adopting depression screening and interpersonal counselling as part of routine care after myocardial infarction. The first stage evaluation of the use of health care services is interesting, and calls for more studies. From the perspective of individual patients, recovery after myocardial infarction seems to consist of many supporting and inhibiting factors. This is something that is important to take into account in developing nursing practice. The results indicate a need for further studies in outcomes of interpersonal counselling and recovery experienced by the patients after myocardial infarction. In addition, the results encourage widening the research perspective to nursing administration and educational level.

Avaliação qualitativa de impactos ambientais considerando as etapas de limpeza e preparo do terreno em plantios florestais no Nordeste paraense

Este trabalho apresenta os resultados da avaliação qualitativa de impactos ambientais na etapa de implantação florestal, considerando-se as atividades de limpeza e preparo do terreno, por meio da aplicação dos métodos de matriz de identificação e interação de impactos, da lista descritiva (checklist) e da combinação/ponderação de atributos. Tal avaliação foi feita com base na identificação e caracterização qualitativa dos impactos ambientais, cujas metodologias possibilitaram a visualização rápida e hierarquizada dos impactos. Através dessa matriz, evidenciaram-se 348 possíveis relações de impactos (capacidade total da matriz), das quais 304 (87,6%) foram identificadas, em que 209 impactos (60,05%) recaíram sobre o meio biofísico e 95 (27,31%) sobre o meio socioeconômico. Dos 209 impactos no meio biofísico, todos apresentaram valor negativo, evidenciando-se ser esse o compartimento ambiental mais impactado negativamente quando da realização das atividades de limpeza e preparo do terreno. Já, dos 95 impactos no meio socioeconômico, 72 (75,78%) foram de valor positivo e 23 (24,21%) de valor negativo, demonstrando que o meio socioeconômico é o compartimento ambiental mais afetado positivamente por ocasião da realização das atividades. Foram identificados os impactos ambientais positivos e negativos mais significantes que, com a combinação/ponderação de atributos, mostraram ser, em sua maioria, de significância média local e regional. Todos os impactos evidenciados apresentaram temporalidade no curto prazo, evidenciando estarem sobre o alcance quanto ao diagnóstico e gestão ambiental adequados. Os resultados contribuem e reafirmam a necessidade de se instituir o processo de avaliação de impactos ambientais na rotina técnico-administrativa da empresa como instrumento de gestão ambiental.

Synthesis of percarboxylic acids in microreactor

Percarboxylic acids are commonly used as disinfection and bleaching agents in textile, paper, and fine chemical industries. All of these applications are based on the oxidative potential of these compounds. In spite of high interest in these chemicals, they are unstable and explosive chemicals, which increase the risk of synthesis processes and transportation. Therefore, the safety criteria in the production process should be considered. Microreactors represent a technology that efficiently utilizes safety advantages resulting from small scale. Therefore, microreactor technology was used in the synthesis of peracetic acid and performic acid. These percarboxylic acids were produced at different temperatures, residence times and catalyst i.e. sulfuric acid concentrations. Both synthesis reactions seemed to be rather fast because with performic acid equilibrium was reached in 4 min at 313 K and with peracetic acid in 10 min at 343 K. In addition, the experimental results were used to study the kinetics of the formation of performic acid and peracetic acid. The advantages of the microreactors in this study were the efficient temperature control even in very exothermic reaction and good mixing due to the short diffusion distances. Therefore, reaction rates were determined with high accuracy. Three different models were considered in order to estimate the kinetic parameters such as reaction rate constants and activation energies. From these three models, the laminar flow model with radial velocity distribution gave most precise parameters. However, sulfuric acid creates many drawbacks in this synthesis process. Therefore, a ´´greener´´ way to use heterogeneous catalyst in the synthesis of performic acid in microreactor was studied. The cation exchange resin, Dowex 50 Wx8, presented very high activity and a long life time in this reaction. In the presence of this catalyst, the equilibrium was reached in 120 second at 313 K which indicates a rather fast reaction. In addition, the safety advantages of microreactors were investigated in this study. Four different conventional methods were used. Production of peracetic acid was used as a test case, and the safety of one conventional batch process was compared with an on-site continuous microprocess. It was found that the conventional methods for the analysis of process safety might not be reliable and adequate for radically novel technology, such as microreactors. This is understandable because the conventional methods are partly based on experience, which is very limited in connection with totally novel technology. Therefore, one checklist-based method was developed to study the safety of intensified and novel processes at the early stage of process development. The checklist was formulated using the concept of layers of protection for a chemical process. The traditional and three intensified processes of hydrogen peroxide synthesis were selected as test cases. With these real cases, it was shown that several positive and negative effects on safety can be detected in process intensification. The general claim that safety is always improved by process intensification was questioned.

Rakennustarkastuksen mobiilityökalun suunnittelu ja toteuttaminen

Rakennusteollisuuden prosessit ovat vielä usein paperipohjaisia, mikä aiheuttaa työmaiden luonteesta johtuen tiedon hajaantumista, hidastaa tiedon siirtymistä ja vaikeuttaa tiedon käsittelyä. Työmaiden väliaikaisilla konttoreilla tiedon määrä voi nousta hallitsemattoman suureksi, mikä haittaa ja hidastaa työnjohdon päätöksentekoa. Käyttämällä sähköisiä työkaluja tiedon keräämistä, keskittämistä ja siirtoa voidaan tehostaa. Projektin tavoitteeksi otettiin teollisuuden laadunvalvonnan tarkastusprosessin tehostaminen ajallisesti käyttämällä tarkastustyöhön sähköistä tarkastuspöytäkirjaa. Tätä varten suunniteltiin sähköinen tarkastusjärjestelmä, joka koostuu kolmesta erillisestä osasta: Tarkastajan mukana kulkeva mobiililaite, jolle tallennetaan suoraan tarkastuksen laatutietoa, palvelinkone avustamaan tiedonsiirrossa ja –varastoinnissa sekä työpöytäsovellus työnjohdon tarpeisiin. Järjestelmää testattiin sähköalan asennuksia tekevässä yrityksessä osana yrityksen normaalia tarkastustyötä. Verrattuna paperiseen pöytäkirjaan sähköinen tarkastusjärjestelmä nopeutti prosessia moninkertaisesti. Nopeustesteissä havaittiin kuitenkin, että valittu tiedon synkronointikirjasto oli järjestelmän tarpeisiin liian hidas. Järjestelmä saavutti sille asetetut tavoitteet tehostamalla prosessia ajallisesti, mutta järjestelmässä on vielä osa-alueita, jotka tarvitsevat jatkokehittämistä.

IFRS-standardien noudattaminen liikearvon raportoinnissa suomalaisissa listayhtiöissä

Tutkimuksen tavoitteena oli tutkia liikearvoon liittyvien IFRS 3- ja IAS 36 –standardien säännösten noudattamista suomalaisten korkean liikearvon määrän omaavien listayhtiöiden tilinpäätöksissä. Teoria muodostettiin tarkastelemalla aihepiirin tieteellisiä julkaisuja, sekä yritysten kirjanpitoa ohjailevia liikearvoon liittyviä säännöksiä. Tutkimusmenetelmä oli kvalitatiivinen, ja empiirisenä aineistona käytettiin viiden yrityksen tilinpäätöksiä vuodelta 2011. Yritykset valittiin tarkastelemalla liikearvon suhteellista osuutta omasta pääomasta. Analysointimenetelmänä käytettiin sisällönanalyysia, ja tutkimuksen runko muodostettiin tilintarkastukseen tarkoitetun tarkastuslistan avulla. Tutkimuksessa tuotettiin tarkkaa ja kuvailevaa tietoa säännösten noudattamisesta kohdeyrityksissä. IFRS 3- ja IAS 36 –standardeissa on määritelty tarkat esitysvaatimukset tilinpäätöksissä esitettävälle liikearvoon liittyvälle tiedolle. Esitettäviä tietoja ovat esimerkiksi kuvaus yritysostojen yhteydessä syntyneestä liikearvosta, sekä selvitys liikearvon arvonalentumistestauksessa käytetyistä avainoletuksista. Kohdeyritysten havaittiin noudattavan tutkimuksessa tarkasteltuja esitysvaatimuksia noin 94 % tarkkuudella. Virheet eivät keskittyneet tiettyihin esitysvaatimuksiin, vaan eri yritykset tekivät erilaisia virheitä liikearvon raportoinnissa.

A global transport packaging guideline for selected business areas

In this Master’s Thesis a global transport packaging guideline for selected business areas was compiled for the Fiskars the company, which provides branded consumer goods for home, garden and outdoor use. The business areas included were Home and Garden business areas. The aim of the guideline was to be a comprehensive guide for the suppliers, product development, operations and external vendors of the company. The guideline consists of written instructions, tables and illustrations that provide useful information for players working with transport packages from sourcing through to shipments. As the role of corporate responsibility and sustainability has grown, a part of responsible manufacturing strategy includes using materials that are re-usable, recyclable or recoverable as energy or through composting. Hence packaging waste management implementations of different regions were also inspected. The resulting guide covers a range of topics concerning packaging and its transport. The topics include legal requirements, restricted materials and substances, preferred materials, markings, labeling of boxes, logistics and distribution center requirements, physical testing and an inspection checklist.