Das GRADE-System: ein internationaler Ansatz zur Vereinheitlichung der Graduierung von Evidenz und Empfehlungen in Leitlinien. [The GRADE System: an international approach to standardize the graduation of evidence and recommendations in guidelines]

Clinical practice guidelines have become an important source of information to support clinicians in the management of individual patients. However, current guideline methods have limitations that include the lack of separating the quality of evidence from the strength of recommendations. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) working group, an international collaboration of guideline developers, methodologists, and clinicians have developed a system that addresses these shortcomings. Core elements include transparent methodology for grading the quality of evidence, the distinction between quality of the evidence and strength of a recommendation, an explicit balancing of benefits and harms of health care interventions, an explicit recognition of the values and preferences that underlie recommendations. The GRADE system has been piloted in various practice settings to ensure that it captures the complexity involved in evidence assessment and grading recommendations while maintaining simplicity and practicality. Many guideline organizations and medical societies have endorsed the system and adopted it for their guideline processes.

Governance by Contract? The impact of the International Finance Corporation's Social Conditionality on Worker Organization and Social Dialogue

This study considers the question of the relationship between private labour regulation and workers' capacity to take collective action through the lens of an empirical study of the International Finance Corporation's (IFC) 'performance standards' system of social and environmental conditionality. The study covered some 150 IFC client businesses in four world regions, drawing on data made public by the IFC as well as the results of a dedicated field survey that gathered information directly from workers, managers and union representatives. The study found that the application of the performance standards system has had remarkably little impact on union membership and social dialogue. In those few cases where change could be causally linked to the standards, the effect depended on the presence of workers' organizations that already had the capacity to take effective action on behalf of their members. The study also uncovered some prima facie evidence of breaches of freedom of association rights occurring with no reaction from IFC. The study concludes that the lack of impact is largely due to the private contractual structure that supposedly guarantees standards compliance.

Pankkien tuloksenjärjestelymahdollisuudet siirryttäessä IFRS-normistoon

Tutkielman ensisijaisena tavoitteena oli määrittää pankkien tuloksenjärjestelymahdollisuuksien muutoksia siirryttäessä kansallisesta FAS GAAP -tilinpäätösnormistosta IFRS-normistoon. Tuloksenjärjestelyn ilmiötä käsiteltiin esittelemällä useita koti- ja ulkomaisia tuloksenjärjestelytutkimuksia. Pankeilla on toimialalleen erityisiä kannustimia tuloksenjärjestelyyn. Pankkitoimialalla tuloksenjärjestely on perinteisesti esiintynyt tuloksentasaamisena tilikausien välillä. Tutkimuksessa saatiin selkeä kuva tuloksenjärjestelymahdollisuuksien muutoksesta. IFRS-normiston sisältämä johdon harkintavalta ilmenee tilinpäätöksen laadintaperiaatteiden valinnaisuutena ja standardien laskelmien sisältäminä johdon arvioina ja oletuksina. Harkintavaltaa käyttämällä johto voi vaikuttaa tilinpäätöksen taseeseen ja tulokseen. IFRS-normistossa tilinpäätöksen laadintaperiaatteisiin liittyvä johdon harkintavalta on vähentynyt verrattuna kansalliseen FAS GAAP-tilinpäätöskäytäntöön, mutta IFRS jättää johdolle edelleen harkintavaltaa muutamien kirjaus- ja raportointikäytäntöjen suhteen. Perinteisten tuloksenjärjestelykeinojen rinnalle IFRS:ssä nousevat useiden standardien laskelmien sisältämät johdon arviot ja oletukset tulevaisuuden muuttujista. Omaisuuserien käypään arvoon arvostamisen myötä tilikauden tuloksista saattaa tulla aikaisempaa volatiilimpia. Käypiin arvoihin arvostamisen seurauksena pankit saattavat siirtyä käyttämään sijoitustensa ostoja ja myyntejä tuloksentasauskeinona. FAS GAAP:ssa pankit ovat käyttäneet tuloksentasaamiseen tiettyjä suoriteperusteisia eriä, esimerkiksi luottotappiovarauksia. IFRS tiukentaa varausten tekemisen periaatteita, mutta tuo tilalle lainakannan arvonalentumistestaukseen sisältyvät johdon arviot.

Profit repatriation of a Polish subsidiary from tax planning point of view of an international corporation

The main purpose of this study was to examine and compare the possibilities of profit repatriation from the point of view of tax planning of an international corporation, in such a case that a Finnish parent company has a subsidiary in Poland. The main research problem was divided into two sub research problems: 1) to examine concepts and principles of international taxation and tax planning from the point of view of international corporations and 2) to discuss the main features of Polish Companies-, Accounting- and Tax Act from the point of view a Finnish parent company. The research method of this study is mainly decision making, comparative analysis. In this study have been discussed the possibilities of international profit repatriation for supporting the decision making of the management of a Finnish parent company. In addition different repatriation possibilities have been compared. In this study has been noticed that a Finnish parent company can repatriate profit of its Polish subsidiary either directly as dividends or by using indirect methods such as interests, royalties, management fees and transfer pricing of goods. The total tax burden of dividends is heavier than the tax burden of indirect methods. It was also concluded that during the last years the Polish legislation has been renewed in order to prevent hidden dividend distribution. This has been done by implementing new rules of transfer pricing and thin capitalization.

Towards actionable international comparisons of health system performance: expert revision of the OECD framework and quality indicators.

OBJECTIVE: To review and update the conceptual framework, indicator content and research priorities of the Organisation for Economic Cooperation and Development's (OECD) Health Care Quality Indicators (HCQI) project, after a decade of collaborative work. DESIGN: A structured assessment was carried out using a modified Delphi approach, followed by a consensus meeting, to assess the suite of HCQI for international comparisons, agree on revisions to the original framework and set priorities for research and development. SETTING: International group of countries participating to OECD projects. PARTICIPANTS: Members of the OECD HCQI expert group. RESULTS: A reference matrix, based on a revised performance framework, was used to map and assess all seventy HCQI routinely calculated by the OECD expert group. A total of 21 indicators were agreed to be excluded, due to the following concerns: (i) relevance, (ii) international comparability, particularly where heterogeneous coding practices might induce bias, (iii) feasibility, when the number of countries able to report was limited and the added value did not justify sustained effort and (iv) actionability, for indicators that were unlikely to improve on the basis of targeted policy interventions. CONCLUSIONS: The revised OECD framework for HCQI represents a new milestone of a long-standing international collaboration among a group of countries committed to building common ground for performance measurement. The expert group believes that the continuation of this work is paramount to provide decision makers with a validated toolbox to directly act on quality improvement strategies.

International comparison of the German evidence-based S3-guidelines on the diagnosis and multimodal treatment of early and locally advanced gastric cancer, including adenocarcinoma of the lower esophagus.

BACKGROUND: Clinical guidelines are essential in implementing and maintaining nationwide stage-specific diagnostic and therapeutic standards. In 2011, the first German expert consensus guideline defined the evidence for diagnosis and treatment of early and locally advanced esophagogastric cancers. Here, we compare this guideline with other national guidelines as well as current literature. METHODS: The German S3-guideline used an approved development process with de novo literature research, international guideline adaptation, or good clinical practice. Other recent evidence-based national guidelines and current references were compared with German recommendations. RESULTS: In the German S3 and other Western guidelines, adenocarcinomas of the esophagogastric junction (AEG) are classified according to formerly defined AEG I-III subgroups due to the high surgical impact. To stage local disease, computed tomography of the chest and abdomen and endosonography are reinforced. In contrast, laparoscopy is optional for staging. Mucosal cancers (T1a) should be endoscopically resected "en-bloc" to allow complete histological evaluation of lateral and basal margins. For locally advanced cancers of the stomach or esophagogastric junction (≥T3N+), preferred treatment is preoperative and postoperative chemotherapy. Preoperative radiochemotherapy is an evidence-based alternative for large AEG type I-II tumors (≥T3N+). Additionally, some experts recommend treating T2 tumors with a similar approach, mainly because pretherapeutic staging is often considered to be unreliable. CONCLUSIONS: The German S3 guideline represents an up-to-date European position with regard to diagnosis, staging, and treatment recommendations for patients with locally advanced esophagogastric cancer. Effects of perioperative chemotherapy versus chemoradiotherapy are still to be investigated for adenocarcinoma of the cardia and the lower esophagus.

The international standardisation arena and the civil society participation stakes : results of the INTERTERM project

International standards are playing an increasingly important role in market governance while frequently exerting direct effects on health, safety and the environment. Yet civil society, more often than not, is absent from the standardisation procedures. The recommendation made here is to foster the participation of civil society actors in standardisation by framing standardisation topics in a way that will encourage the mobilisation of these actors in accordance with their repertoire of actions and interests and by organising the plural expertise required for the effective participation that is necessary if they are to exert an influence.

Creating and implementing a financial management process to an international company

The objectives of this thesis areto identify the best elements from Information Technology Infrastructure Library financial management for an international company. The elements need to be customized to fit existing elements and the thesis needs to provide implementation proposal. The new IT financial management needs to improve cost visibility and bring benefits to the company. In order to find the best elements for IT financial management, there needs to be a research to discover the companys business needs. The ITIL library is used to find answers and solutions to the companys issues in IT financial management. Other IT frameworks can and will be used as well, if they are able to work with ITIL model. ITIL consists from budgeting, accounting and charging in IT financial management, which all needs to be investigated. In addition more ITIL elements such as contract management and supplier management can be used, in order to make IT financial management work better.

IAS 39 -standardin mukainen suojauslaskenta ja rahavirran suojaus suomalaisissa pörssiyhtiöissä

Tutkielman tavoitteena oli tutkia IAS 39 -standardin mukaista suojauslaskentaa ja rahavirran suojauksen soveltamista neljässä suomalaisessa pörssiyhtiössä kolmelta eri toimialalta. Tutkielman perusteella suojauslaskennan soveltamisessa ei havaittu suuria eroavaisuuksia eri toimialojen yhtiöiden välillä. Tutkielmassa päädyttiin johtopäätökseen, että suojauslaskennan soveltamiseen vaikuttaa enemminkin yhtiön liikevaihdon suuruus ja liiketoiminnan laajuus kuin esimerkiksi toimialan luonne. Suojauslaskennan mahdollistama tuloksen volatiliteetin tasaaminen on ensisijainen ja suurin hyöty. Tuloksiin kohdistunut huomio on nykypäivänä kasvanut, ja myös sen vuoksi tuloksen muutosten eliminointi ja suojauslaskenta on yhtiöiden mukaan tärkeää. Soveltamista harkittaessa prosessia tarkastellaan monesta eri näkökulmasta. Nykyisellä taloustilanteella on ollut vaikutuksia yhtiöiden liiketoimintaan ja suojauksiin, mutta suojauslaskentaan vain välillisesti.

Improving and User Interface to E-Procurement Software Used in Asset Accounting and Investigating Effects to Efficiency

This diploma thesis has been done to international organization which takes care from the accounting actions of two major companies. In this organization are used three different purchasing tools which are used when new asset master data is wanted to input to SAP R/3- system. The aim of this thesis is to find out how much changing the user interface of one of these three e-procurement programs will affect to overall efficiency in asset accounting. As an addition will be introduced project framework which can be used in future projects and which help to avoid certain steps in the development process. At the moment data needs to be inputted manually with many useless mouse clicks and data needs to be searched from many various resources which slow down the process. Other organization has better tools at the moment than the myOrders system which is under investigation Research was started by exploring the main improvement areas. After this possible defects were traced. Suggested improvements were thought by exploring literature which has been written from usability design and research. Meanwhile also directional calculations from the benefits of the project were done alongside with the analysis of the possible risks and threats. After this NSN IT approved the changes which they thought was acceptable. The next step was to program them into tool and test them before releasing to production environment. The calculations were made also from implemented improvements and compared them to planned ones From whole project was made a framework which can be utilized also to other similar projects. The complete calculation was not possible because of time schedule of the project. Important observation in the project was that efficiency is not improved not only by changing the GUI but also improving processes without any programming. Feedback from end user should be also listened more in development process. End-user is after all the one who knows the best how the program should look like.

Compliance of crane electrics with electrical safety standards and codes

Master’s thesis focuses on the questions of crane electrics compliance with electrical safety standards. Overview and short comparison of the world’s effective standards in the field is made in order to understand their demands. Basic concepts of a proper electrical circuit design are presented. Characteristics, construction and operation principles of overcurrent protective devices are studied in details. Electrics of the basic crane is designed according to the assumed customer’s demands, compliance with the requirements of the standards is checked. Solutions to achieve better compliance in some issues are proposed. Accent is made on the National Electrical Code (NEC) and standards by Underwriters Laboratories (UL) latests demands. Requirements of the International Electrotechnical Commission (IEC) are also taken into account.

Self assessment report for international accreditation - Bachelor's and Master's degree programmes in Mechanical Engineering

Itsearviointiraportissa kuvataan Lappeenrannan teknillisen yliopiston konetekniikan kandidaatin ja diplomi-insinöörin tutkinto-ohjelmat opetussuunnitelman 2011-2012 mukaisesti. Itsearviointiraportti on tuotettu saksalaisen ASIIN-akkreditointiorganisaation raportointimallin mukaisesti.

Sähköisen taloushallinnon kehitys ja ilmiön näkyvyys alan ammattilehtikirjoittelussa

Pro gradu –tutkielman ensisijaisena tavoitteena on tutkia sähköisen ta-loushallinnon kehitystä ja miten se on näkynyt alan suomalaisessa ja kansainvälisessä ammattilehtikirjoittelussa vuosina 1997 – 2013. Tarkoi-tuksena on löytää kirjoittelun perusteella sähköisen taloushallinnon kehi-tyksen edistäviä ja hidastavia tekijöitä sekä minkälaisia tulevaisuuden näkymiä artikkelit luovat sähköiselle taloushallinnolle. Lisäksi tavoitteena on löytää yhtäläisyyksiä ja eroja kansallisen ja kansainvälisen kirjoittelun välillä. Tutkielma on laadullinen tutkimus ja tutkimusmenetelminä käytetään si-sällönanalyysia, sisällönerittelyä, teemoittelua ja vertailevaa tutkimusta. Tutkielman empiirinen aineisto koostuu Tilisanomien, Balanssi–lehden ja Accountancy–lehden sähköistä taloushallintoa koskevista artikkeleista aikavälillä 1997 – 2013. Tutkimustulosten perusteella sähköisen taloushallinnon kehityskulku näkyy myös ammattilehtikirjoittelussa. Tietojärjestelmät ja niiden käytön mahdollistava lainsäädäntö ovat sähköisen taloushallinnon perusedelly-tykset. Suurimpia kehityksen edistäjiä ovat julkinen valta, verkkolaskut ja standardointi. Kehityksen hidastajina nähdään yhtenäisten standardien puute ja asenteet. Sähköisen taloushallinnon tulevaisuuden näkymiä ovat standardoidut prosessit ja käsitteet koko taloushallinnon alueella sekä viranomaisraportointi XBRL-kielen avulla. Suurimmat erot kansalli-sessa ja kansainvälisessä kehityksessä on havaittavissa verkkolaskuissa ja XBRL-raportoinnissa. Johtopäätöksenä todetaan että kirjoittelun perusteella voidaan löytää sähköisen taloushallinnon kehitystä hidastavia ja edistäviä tekijöitä ja se luo viitteitä tulevaisuuden kehitykselle. Sähköinen taloushallinto kehittyy kunkin maan valtiovallan tahtotilan ja lainsäädännön mukaan. Jatkotut-kimuskohteena tutkielmaa voisi laajentaa kansainvälisemmäksi ottamalla mukaan tarkasteluun useampia kansainvälisiä lehtiä ja kansainvälistä lainsäädäntöä.

The collective dimension of freedom of religion or belief in international law : the application of findings to the case of Turkey

Pertinent domestic and international developments involving issues related to tensions affecting religious or belief communities have been increasingly occupying the international law agenda. Those who generate and, thus, shape international law jurisprudence are in the process of seeking some of the answers to these questions. Thus the need for reconceptualization of the right to freedom of religion or belief continues as demands to the right to freedom of religion or belief challenge the boundaries of religious freedom in national and international law. This thesis aims to contribute to the process of “re-conceptualization” by exploring the notion of the collective dimension of freedom of religion or belief with a view to advance the protection of the right to freedom of religion or belief. The case of Turkey provides a useful test case where both the domestic legislation can be assessed against international standards, while at the same time lessons can be drawn for the improvement of the standard of international review of the protection of the collective dimension of freedom of religion or belief. The right to freedom of religion or belief, as enshrined in international human rights documents, is unique in its formulation in that it provides protection for the enjoyment of the rights “in community with others”.1 It cannot be realized in isolation; it crosses categories of human rights with aspects that are individual, aspects that can be effectively realized only in an organized community of individuals and aspects that belong to the field of economic, social and cultural rights such as those related to religious or moral education. This study centers on two primary questions; first, what is the scope and nature of protection afforded to the collective dimension of freedom of religion or belief in international law, and, secondly, how does the protection of the collective dimension of freedom of religion or belief in Turkey compare and contrast to international standards? Section I explores and examines the notion of the collective dimension of freedom of religion or belief, and the scope of its protection in international law with particular reference to the right to acquire legal personality and autonomy religious/belief communities. In Section II, the case study on Turkey constitutes the applied part of the thesis; here, the protection of the collective dimension is assessed with a view to evaluate the compliance of Turkish legislation and practice with international norms as well as seeking to identify how the standard of international review of the collective dimension of freedom of religion or belief can be improved.