Co-evolution of Policy Sectors: Health Care and Public Health in five Countries

Cette thèse analyse la co-évolution de deux secteurs dans la politique de la santé: santé publique (public health) et soins aux malades (health care). En d'autres termes, la relation entre les dimensions curative et préventive de la politique de la santé et leur développement dans la durée. Une telle recherche est nécessaire car les problèmes de la santé sont complexes et ont besoin de solutions coordonnées. De plus, les dépenses de la santé ont augmenté sans arrt durant les dernières décennies. Un moyen de réduire une future augmentation des dépenses pourrait consister en davantage d'investissement dans des mesures préventives. En relation avec cette idée, ma recherche analyse les politiques de la santé publique et les soins aux malades de cinq pays: Allemagne, Angleterre, Australie, Etats-Unis et Suisse. En m'appuyant sur la littérature secondaire, des statistiques descriptives et des entretiens avec des experts et des politiciens, j'analyse la relation entre les deux secteurs depuis la fin du dix-neuvième siècle. En particulier, je me focalise sur la relation des deux champs sur trois niveaux: institutions, acteurs et politiques. Mes résultats montrent les similitudes et les différences d'évolution entre les cinq pays. D'un c^oté, lorsque la profession médicale est politiquement active et que le pays consiste en une fédération centralisée ou en un gouvernement unitaire, les deux secteurs sont intégrés au niveau institutionnel, ralliant les professions et groupes d'intérêt des deux secteurs la cause commune dans une activité politique. Par contre, dans tous les pays, les deux secteurs ont co-évolué vers une complémentarité malgré de la politisation des professions et la centralisation du gouvernement. Ces résultats sont intéressants pour la science politique en général car ils soulignent l'importance des professions pour le développement institutionnel et proposent un cadre pour l'analyse de la co-évolution des politiques publiques en général. -- This Ph.D. thesis analyzes the co-evolution of the health care and the public health sectors. In other words, the relation between preventive and curative health policy and its evolution over time. Such research is necessary, because current health problems are complex and might need coordinated solutions. What is more, health expenditures have increased continuously in the last decades. One way to slow down further increase in health spending could be to invest more in preventative health policies. Therefore, I am connecting individual health care and public health into a common analysis, taking Australia, Germany, Switzerland, the UK and the U.S. as examples. Based on secondary literature, descriptive statistics and interviews with experts and policymakers, I am analyzing how the two sectors' relations co-evolved between the late nineteenth and the early twenty-first century. Specifically, I am researching how health care and public health were related on the levels of institutions, actors and policies. My results show that there are differences and similarities in the co-evolution of policy sectors between these countries. On the one hand, when the medical profession was politically active and the country a centralized federation or a unitary state, there was institutional integration and common political advocacy of the sectors' interest groups and professions. On the other hand, in all countries, both sectors co-evolved towards complementarity, irrespectively of the politicization of professions and centralization of government. These findings are interesting for the political science literature at large, because they underline the importance of professions for institutional development and propose an analytical framework for analyzing the co-evolution of policy sectors in general.

A System-Level Simulation Model for a Protocol Processor

As the development of integrated circuit technology continues to follow Moore’s law the complexity of circuits increases exponentially. Traditional hardware description languages such as VHDL and Verilog are no longer powerful enough to cope with this level of complexity and do not provide facilities for hardware/software codesign. Languages such as SystemC are intended to solve these problems by combining the powerful expression of high level programming languages and hardware oriented facilities of hardware description languages. To fully replace older languages in the desing flow of digital systems SystemC should also be synthesizable. The devices required by modern high speed networks often share the same tight constraints for e.g. size, power consumption and price with embedded systems but have also very demanding real time and quality of service requirements that are difficult to satisfy with general purpose processors. Dedicated hardware blocks of an application specific instruction set processor are one way to combine fast processing speed, energy efficiency, flexibility and relatively low time-to-market. Common features can be identified in the network processing domain making it possible to develop specialized but configurable processor architectures. One such architecture is the TACO which is based on transport triggered architecture. The architecture offers a high degree of parallelism and modularity and greatly simplified instruction decoding. For this M.Sc.(Tech) thesis, a simulation environment for the TACO architecture was developed with SystemC 2.2 using an old version written with SystemC 1.0 as a starting point. The environment enables rapid design space exploration by providing facilities for hw/sw codesign and simulation and an extendable library of automatically configured reusable hardware blocks. Other topics that are covered are the differences between SystemC 1.0 and 2.2 from the viewpoint of hardware modeling, and compilation of a SystemC model into synthesizable VHDL with Celoxica Agility SystemC Compiler. A simulation model for a processor for TCP/IP packet validation was designed and tested as a test case for the environment.

Application of intravoxel incoherent motion perfusion imaging to shoulder muscles after a lift-off test of varying duration.

Intravoxel incoherent motion (IVIM) MRI is a method to extract microvascular blood flow information out of diffusion-weighted images acquired at multiple b-values. We hypothesized that IVIM can identify the muscles selectively involved in a specific task, by measuring changes in activity-induced local muscular perfusion after exercise. We tested this hypothesis using a widely used clinical maneuver, the lift-off test, which is known to assess specifically the subscapularis muscle functional integrity. Twelve shoulders from six healthy male volunteers were imaged at 3 T, at rest, as well as after a lift-off test hold against resistance for 30 s, 1 and 2 min respectively, in three independent sessions. IVIM parameters, consisting of perfusion fraction (f), diffusion coefficient (D), pseudo-diffusion coefficient D* and blood flow-related fD*, were estimated within outlined muscles of the rotator cuff and the deltoid bundles. The mean values at rest and after the lift-off tests were compared in each muscle using a one-way ANOVA. A statistically significant increase in fD* was measured in the subscapularis, after a lift-off test of any duration, as well as in D. A fD* increase was the most marked (30 s, +103%; 1 min, +130%; 2 min, +156%) and was gradual with the duration of the test (in 10(-3) mm(2) /s: rest, 1.41 ± 0.50; 30 s, 2.86 ± 1.17; 1 min, 3.23 ± 1.22; 2 min, 3.60 ± 1.21). A significant increase in fD* and D was also visible in the posterior bundle of the deltoid. No significant change was consistently visible in the other investigated muscles of the rotator cuff and the other bundles of the deltoid. In conclusion, IVIM fD* allows the demonstration of a task-related microvascular perfusion increase after a specific task and suggests a direct relationship between microvascular perfusion and the duration of the effort. It is a promising method to investigate non-invasively skeletal muscle physiology and clinical perfusion-related muscular disorders.

Platform pricing and consumer foresight: The case of airports

Airports have become platforms that derive revenues from both aeronautical and commercial activities. The demand for these services is characterized by a one-way complementarity in that only air travelers can purchase retail goods at the airport terminals. We analyze a model of optimal airport behavior in which this one-way complementarity is subject to consumer foresight, i.e., consumers may not anticipate in full the ex post retail surplus when purchasing a flight ticket. An airport sets landing fees, and, in addition, also chooses the retail market structure by selecting the number of retail concessions to be awarded. We find that, with perfectly myopic consumers, the airport chooses to attract more passengers via low landing fees, and also sets the minimum possible number of retailers in order to increase the concessions’ revenues, from which it obtains the largest share of profits. However, even a very small amount of anticipation of the consumer surplus from retail activities changes significantly the airport’s choices: the optimal airport policy is dependent on the degree of differentiation in the retail market. When consumers instead have perfect foresight, the airport establishes a very competitive retail market, where consumers enjoy a large surplus. This attracts passengers and it is exploited by the airport by charging higher landing fees, which then constitute the largest share of its profits. Overall, the airport’s profits are maximal when consumers have perfect foresight. Keywords: two-sided markets, platform pricing, one-way demand complementarity, consumer foresight. JEL classification: L1, L2, L93.

Optimised Utilization of Bioenergy in Poland

The aim of the study was to ford out the availability of biomasses, which are available for energy production, in Poland. Biomasses which were examined were forest residues and surplus straw. Availability was examined by 16 Polish voivodeships, which are provinces in Poland. After fording out the amounts of biomasses for energy production was examined the need of biomass in the biggest CHP plants in Poland. It was expected that all the plants uses 15 % of biomass as the fuel. In the first parts of the report are explained the legislation which effects to biomass use in energy production in EU level and in Polish level. Also the combustion methods best for biomasses are explained by examples. After this, is studied the general situation of renewable energy use in Poland and the facts about the country. In the last parts it's explained the calculations and is shown the example cases. When it was found out the needs and supply of biomass it was examined by examples how it could be transported to the plants from the producers. Also was examined costs effected, if there were logistical terminals between the producer and the end user. The estimation was done by setting prices for the biomass, and fording out average costs for producing and transporting biomass. There are a lot of surplus biomasses in Poland which could be used for energy production, and this is a one way to reach the goals that EU has set of renewable energies. But because biomasses doesn't have such a good calorific value, it isn't worth able to transport it very long distances. In the research was set the prices for producer 9€/MWh and for end user 15€/MWh, the maximum transportation distance for forest residues was 52 km and for straw 56 km. These are example estimations and it has to be remembered that there are a lot of factors that makes inaccurate. The model is really sensitive and by changing one parameter the results change a lot.

Perustutkimus palveluinnovaatioprosessissa rahoitusalalla

Palveluinnovaatioprosessi voidaan jakaa 5 eri vaiheeseen: strategiasidonnaisuus, perustutkimus, suorituskyvyn analysointi, systeemimuutokset sekä kaupallistaminen. Tästä palveluinnovaatioprosessista voidaan johtaa perustutkimusprosessi rahoitusalalle: strategiasidonnaisuus, ideoiden luonti ja karsinta, suorituskyvyn analysointi, differointimahdollisuuksien kartoittaminen ja palveluinnovaation myynti yritysjohdolle sekä osakkaille. Strategiasidonnaisuudella varmistetaan, että yritys pysyy omalla osaamisalueellansa hyödyntämällä omia ydinkompetenssejaan. Perustutkimus osana palveluinnovaatioprosessia selvittää oleellisimmat tiedot markkinatilanteesta sekä toimii ohjaavana että karsivana tekijänä uuden tuotteen jatkotoimenpiteille. Yrityksen kyvykkyyksien mittaaminen perustutkimusta varten on oleellinen vaihe uuden palvelun vaatimien liiketoiminnallisten muutosten määrittämiseksi. Tuotedifferoinnilla voidaan luoda kilpailullista etua tuotteiden puolesta homogeenisilla markkinoilla, joissa kilpailu tapahtuu pääosin hinnoittelussa. Rahoitusalalla tuotedifferointi voi muodostua haastavaksi kuluttajien suhtautuessa konservatiivisesti uusiin tuotteisiin. Makroekonomisten tekijöiden perusteella voidaan päätellä, että suomalaiset kuluttajat ottavat lainaa tulevaisuudessakin. Asuntolaina on ollut lainamarkkinoilla luottokannan kasvun veturina ja tästä syystä uudet asuntolainan kaltaiset tuotteet voisivat olla menestyksekkäitä. Kilpailu asuntolainamarkkinoilla kulminoituu kolmen hallitsevan kilpailijan ympärille: Osuuspankki, Sampo Pankki ja Nordea. Asuntolainan kaltainen käänteinen asuntolaina voisi olla menestys markkinoilla, jos sitä pystyttäisiin differoimaan kylliksi. Markkinapotentiaali pelkälle käänteiselle asuntolainalle on tällä hetkellä liian alhainen. GE Money Finland ei myöskään pysty tarjoamaan tuotetta yhtä kilpailulliseen hintaan kuin kilpailijansa. GE Money Finlandin tulisi edellä mainituista syistä johtuen pyrkiä differoimaan käänteisen asuntolainan kaltaista tuotettaan Heloc, jotta se menestyisi markkinoilla.

Microwave Slot Transmission Line Filled with Ferroelectric and Ferromagnetic Layers

Now when the technology is fast developing it is very important to investigate new hybrid structures. One way is to use ferrite ferroelectric layered structures. Theoretical and experimental investigation of such structures was made. These structures have advantages of both layers and it is possible to tune the behavior of this structure by external electric and magnetic field. But these structures have some disadvantages connected with presence of thick ferroelectric layer. One way to overcome this problem is to use slotline. So this is another new way to create hybrid ferrite ferroelectric structures, but it is needed to create new theory and find experimental proof that the behavior of these structures can be tuned with external magnetic and electric fields.

Funcionalização de nanotubos de Carbono

Carbon nanotubes are very stable systems having considerable chemical inertness due to the strong covalent bonds of the carbon atoms on the nanotube surface. Many applications of carbon nanotubes require their chemical modification in order to tune/control their physico-chemical properties. One way of achieving this control is carrying out functionalization processes where atoms and molecules interact (covalent or non-covalent) with the nanotubes. We review some of the progress that has been made in chemical functionalization of carbon nanotubes. Emphasis is given to chemical strategies, the most used techniques, and applications.

Hiilidioksidin talteenottoon soveltuvan anioninvaihtohartsin valmistus ja karakterisointi

Tämän työn tarkoituksena oli tutkia hiilidioksidin talteenottoon soveltuvan anioninvaihtohartsin valmistusmenetelmiä, kokeilla eri menetelmiä käytännössä ja tutkia sekä itse valmistettujen että valmiina saatujen hartsien adsorptiokykyä ja muita ominaisuuksia. Kemiallinen adsorptio amiiniryhmän omaavien hartsien avulla on yksi tapa sitoa hiilidioksidia ilmasta. Primäärinen amiiniryhmä sitoo hiilidioksidia parhaiten. Primäärisen amiiniryhmän omaava anioninvaihtohartsi voidaan valmistaa pohjapolymeeristä halogeenialkyloimalla ja aminoimalla, aminoalkyloimalla tai suoraan aminoimalla. Aminoalkylointi voidaan suorittaa erilaisilla reagensseilla ja katalyyteillä. Tässä työssä hartseja valmistettiin aminoimalla polymetyyliakrylaattidivinyylibentseenipohjaista polymeeriä etyylidiamiinilla ja propyylidiamiinilla. Lisäksi suoritettiin polystyreeni-divinyylibentseenipohjaisen polymeerin aminoalkylointi bis(ftaali-imidometyyli)eetterin avulla. Reaktio tehtiin kahdella eri katalyytillä; rikkitrioksidilla ja rautakloridilla. Aminoalkylointireaktioissa tarvittava eetteri piti ennen varsinaista reaktiota valmistaa N-hydroksymetyyliftaali-imidistä. Myös tämän reagenssin syntetisointia ftaali-imidistä kokeiltiin. Kaikki synteesit onnistuivat melko hyvin, paitsi aminoalkylointi rautakloridikatalyytillä. Hartsien valmistuksen lisäksi itse valmistettuja primäärisen amiiniryhmän omaavia hartseja sekä erilaisia amiiniryhmiä omaavia valmiita hartseja karakterisoitiin eri tavoin. Erityisesti haluttiin tutkia hiilidioksidin adsorptiokapasiteettia ja hartsien termistä kestävyyttä. Kaikista tutkituista hartseista lähimpänä haluttuja ominaisuuksia olivat kaksi kaupallista primäärisen amiiniryhmän omaavaa PS-DVBpohjaista makrohuokoista hartsia. Rakenteeltaan samanlainen itse valmistettu hartsi (rikkitrioksidikatalyytin läsnä ollessa aminoalkyloitu) oli myös ominaisuuksiltaan lupaava. Valmistusmenetelmää pitää kuitenkin tutkia ja kehittää lisää vielä parempien tulosten aikaansaamiseksi. Myös kaupallinen polyetyleeni-imiinirakenteen omaava silikapohjainen hartsi oli ominaisuuksiltaan hyvä.

Aprendizagem baseada em problemas: uma experiência no ensino de química toxicológica

This article describes a Problem-Based Learning (PBL) experience that taught organophosphorus pesticides chemistry, its human health effects and acetylcholinesterase assay to secondary students. The teaching process was based on a real intoxication case and ended with students' activities report presentation. The apparent lack of teacher reference and inexistence of a curriculum based on a strict textbook in which PBL is based on leads inexperienced students to insecurity and the idea that teachers are not doing there jobs. One way to minimize this situation is to use real cases in other to interest students as stakeholders of central problem solution.

Estudio de copolimerización injerto del acrilato de butilo sobre almidón empleando sistema iniciador redox

The mixture of synthetic and natural materials yields a material with improved physical-chemical properties. One way of obtaining this kind of material is through graft copolymerization. Some natural materials have been used in graft copolymerization with synthetic monomers. In this work, graft copolymerization of butyl acrylate (BA) onto starch using a redox initiator system was carried out. The graft yield was evaluated for different reaction conditions. The graft copolymer was characterized by infrared spectroscopy, thermal analysis and scanning electron microscopy (SEM).

Nordic Perspectives on Encountering Foreignness

The foreign can be revered, produced, reproduced, submerged, feared or suppressed, but it has never failed to engage one way or the other. In this volume, a multidisciplinary research network Enfore (Encountering Foreignness – Nordic Perspectives since the Eighteenth Century) focuses on the cultural dynamics of “foreignness”. The authors explore the continuous negotiation between “ours” and “theirs” and the making of “our” place in the context of the wider world. They are using the concept of foreignness as an analytical tool for making visible this heterogeneous, variable and diverse phenomenon. Drawing on the findings within the Nordic context, the group will contribute to an understanding of the general processional and dynamic character of foreignness and of the relationship between metropolitan centers and peripheral areas elsewhere in Europe and in the wider world.

Sovellusintegraation toteutus pk-yrityksen projektijärjestelmiin

Tässä diplomityössä käydään läpi lähestymistapoja sovellusintegraatioon ja niiden käyttöä yritysmaailmassa. Sovellusintegraatiolla tarkoitetaan prosessia jolla yhdistetään toimintoja tai tietoa kahdesta tai useammasta sovelluksesta ja luodaan yhtenäinen kokonaisuus toiminnallisuuksia tai tietoa. Sovellusintegraation toteuttamiseksi on olemassa erilaisia lähestymistapoja ja menetelmiä. Näillä prosesseilla pyritään linkittämään kaksi tai useampia sovelluksia toisiinsa. Sovellusintegraation avulla saadaan jo olemassa olevista järjestelmistä tietoa, pystytään hyödyntämään elektronista kaupankäyntiä, saadaan integroituja toimitusketjuja, ja saadaan jaettua tarpeelliset prosessit. Sovellusintegraatio on strateginen lähestymistapa monen tietojärjestelmän yhteensitomiseksi. Tietojen vaihto ja reaaliaikainen toiminta on tärkeää. Sovellusintegraation tuloksena käytettävissä oleva informaatio ja prosessit sisäisten- ja ulkoisten systeemien välillä tuottavat selkeää strategista etua. Työssä toteutettiin kohdeyritykselle järjestelmä jonka avulla voidaan siirtää työtunnit projektinhallintajärjestelmästä taloushallinnon järjestelmään.

Kustannukset ja kannattavuus RFID- ja toiminnanohjausjärjestelmien integrointiprojektissa

Maailmantalouden jyrkkä lasku vuonna 2008 ajoi yritykset säästökuurille. Säästöjä pyritään saamaan esimerkiksi automatisoimalla toimintoja. Yksi tapa luoda kustannussäästöjä on käyttää RFIDteknologiaa varastoinnin toimien tehostukseen. Tämän tutkimuksen pääasiallisena tavoitteena on ollut rakentaa yksinkertainen laskentamalli RFID- ja toiminnanohjausjärjestelmien integrointiprojektin kustannusten ja kannattavuuden laskemiseen. Toisena tavoitteena on ollut selvittää, mitkä tekijät vaikuttavat investoinnin kannattavuuteen. Tutkimus rajattiin tarkastelemaan varaston saapuvan tavaran vastaanoton prosessia ja sen toimintojen automatisointia RFID-järjestelmän avulla. Laskentamalli muodostuu kolmesta osasta: investoinnin kokonaiskustannusten arvioinnista, investoinnista saatavien kustannussäästöjen arvioinnista ja kannattavuuslaskelmista. Investointien kokonaiskustannusten arviointia varten rakennettiin luettelo yleisimmistä kustannuslajeista. Investoinnista saatavien kustannussäästöjen arviointi tehtiin analysoimalla nykyprosesseja ja etsimällä niistä toimintoja, jotka tehostuvat RFID-järjestelmän avulla. Varsinaisina kannattavuuslaskentamenetelminä käytettiin investoinnin takaisinmaksuajan menetelmää sekä pääoman tuottoasteen menetelmää. Tutkimuksen tuloksena todettiin rakennetun laskentamallin soveltuvan hyvin investoinnin kustannusten ja kannattavuuden arviointiin. Samalla havaittiin yrityksen toimialan, saapuvien lähetysten määrän ja lähetysten rivimäärän vaikuttavan merkittävästi RFID- jatoiminnanohjausjärjestelmän integrointiprojektin kannattavuuteen.

Coaching agile methods in research and development projects

Agile coaching of a project team is one way to aid learning of the agile methods. The objective of this thesis is to present the agile coaching plan and to follow how complying the plan affects to the project teams. Furthermore, the agile methods are followed how they work in the projects. Two projects are used to help the research. From the thesis point of view, the task for the first project is to coach the project team and two new coaches. The task for the second project is also to coach the project team, but this time so that one of the new coaches acts as the coach. The agile methods Scrum process and Extreme programming are utilized by the projects. In the latter, the test driven development, continuous integration and pair programming are concentrated more precisely. The results of the work are based on the observations from the projects and the analysis derived from the observations. The results are divided to the effects of the coaching and to functionality of the agile methods in the projects. Because of the small sample set, the results are directional. The presented plan, to coach the agile methods, needs developing, but the results of the functionality of the agile methods are encouraging.