Jejunum and ileum blunt trauma: what has changed with the implementation of multislice computed tomography?

OBJECTIVE: to evaluate the impact of the new technology of multidetector computed tomography (MDCT) in improving the accuracy and early diagnosis of BSBI.METHODS: patients with blunt small bowel injuries (BSBI) grade> I were identified retrospectively and their CT scans reviewed by an experienced radiologist. Clinical and tomographic findings were analyzed and patients grouped as "pre-MDCT" and "post-MDCT", according to the time of implementation of a 64-slice MDCT.RESULTS: of the 26 patients with BSBI 16 had CT scans. Motor vehicle collision (62.5%) was the most frequent mechanism of injury. In the pre-MDCT period, five of the 13 patients (38.5%) had abdominal CT, and in the post-MDCT, 11 of 13 patients (84.6%) had the exam. During pre-MDCT, all CT scans were abnormal with findings of pneumoperitoneum (60%), free fluid (40%) and bowel wall enhancement (20%). In the post-MDCT group, all exams but one were abnormal and the most frequent findings were free fluid (90.9%), bowel wall enhancement (72.7%), and pneumoperitoneum (54.5%). However, the rate of delayed laparotomy did not change. The mortality rate in both groups were similar, with 20% during pre-MDCT and 18.2% during post-MDCT.CONCLUSION: the use of MDCT in abdominal trauma in our service has increased the sensibility of the diagnosis, but has had no impact on outcome so far.

Marketers’ perception of the implementation of social media marketing: Evidence from large Finnish companies’ marketing campaigns

Social media is a multidimensional marketing and communications channel which can support and enhance a business’ reputation, sales and even longevity. Social media as a business tool encourages an interaction between customers and companies which gives opportunities for a company to better understand their customers, to target them more effectively and to collaborate and create dialogues with them which is not possible through traditional media channels. The aim of a social media strategy is to increase brand awareness, image, loyalty and recognition. The peer networks that social media creates allows a company to disseminate information through loyal customers to new and prospective customers to ultimately increase reach. The purpose of the study is to understand the marketer’s perspective of social media marketing use and how it is currently utilized in marketing and communications activities in Finland. Three companies were interviewed covering fourteen different implementations of social media marketing campaigns. These were then analysed to ascertain the utilization methods and experience gained on recent campaigns in the Finnish market The utilization of social media marketing was analysed using the methods of thematic analysis and inductive and abductive reasoning. Elements and themes were drawn out of the separate interviews to create a framework with which to explore, evaluate and match theories that define social media usage by companies. It became clear from all of the interviews that social media as a tool is most effective when it captures the viewer’s interest through rich and entertaining content. This directed the theoretical research towards Engagement Theory and Content Marketing which look to emphasize the importance of communities, collaboration, interaction, and peer-sharing as the key drivers of a social media marketing campaign.

Toiminnanohjausjärjestelmän käyttöönotto varastojen ja työkalujen hallintaan

Tämä diplomityö käsittelee toiminnanohjausjärjestelmän käyttöönottoprojektia varastojen ja työkalujen hallintaan TeollisuusSepät Oy:ssä. Tämän työn käyttöönottoprojektissa laajennetaan yrityksessä jo olemassa olevan toiminnanohjausjärjestelmän käyttöä, ottamalla se käyttöön myös yrityksen varastojen ja työkalujen hallintaan. Käyttöönottoprojektin tavoitteena on lyhentää tuotteiden kiertoaikaa varastossa ja pienentää varastoon sitoutuvaa pääomaa sekä saada työkalujen tiedot yhteen tietokantaan. Työn teoriaosuudessa käsitellään toiminnanohjausjärjestelmää yleisesti ja sen käyttöönotto liittyviä vaiheita sekä muutosvastarintaa ja onnistuneen muutoksen vaiheita. Empiria osuudessa käydään läpi toiminnanohjausjärjestelmän käyttöönottoprojekti varastojen ja työkalujen hallintaan TeollisuusSepät Oy:ssä ja käyttäjien tyytyväisyyttä toiminnanohjausjärjestelmän käyttöön käyttöönottoprojektin jälkeen. Käyttöönottoprojektin jälkeen havaitaan, että käyttäjät ovat tyytyväisiä toiminnanohjausjärjestelmän käyttöön varastojen ja työkalujen hallintaan. Projektin aikana on myös ilmennyt uusia mahdollisia käyttökohteita toiminnanohjausjärjestelmälle TeollisuusSepät Oy:ssä.

Design and implementation of a production synchronization extension for Microsoft Dynamics AX

In a just-in-time, assemble-to-order production environments the scheduling of material requirements and production tasks - even though difficult - is of paramount importance. Different enterprise resource planning solutions with master scheduling functionality have been created to ease this problem and work as expected unless there is a problem in the material flow. This case-based candidate’s thesis introduces a tool for Microsoft Dynamics AX multisite environment, that can be used by site managers and production coordinators to get an overview of the current open sales order base and prioritize production in the event of material shortouts to avoid part-deliveries.

The Use of Nervous System Drugs and the Risk of Fractures in Old Adults

Hermostoon vaikuttavien lääkkeiden käyttö on yleistä iäkkäässä väestössä. Erityisen yleistä käyttö on pitkäaikaisessa laitoshoidossa asuvilla iäkkäillä. Hermostoon vaikuttavien lääkkeiden haittavaikutuksia on tutkittu paljon, ja useat hermostoon vaikuttavat lääkeaineryhmät on tunnistettu murtumien riskitekijöiksi. Aikaisemmin ei ole kuitenkaan tutkittu usean hermostoon vaikuttavan lääkkeen yhteiskäytön yhteyksiä murtuman riskiin 65 vuotta täyttäneillä. Väitöskirjatutkimuksessa havaittiin, että usean hermostoon vaikuttavan lääkeaineen yhtäaikainen käyttö oli hyvin yleistä Porin kaupunginsairaalan viidellä pitkäaikaisen laitoshoidon osastolla (n = 154) vuosien 2004 ja 2005 vaihteessa. Kolmasosa tutkituista käytti säännöllisesti kolmea tai useampaa hermostoon vaikuttavaa lääkettä samanaikaisesti. Kun huomioitiin myös tarvittaessa otettavat lääkkeet, vastaava luku oli 53 %. Tutkimuksessa havaittiin myös viitteitä lääkkeiden epäasianmukaisesta käytöstä, kun potilaiden käyttämiä lääkkeitä verrattiin heidän kognitiiviseen ja fyysiseen suorituskyynsä sekä asetettuihin diagnooseihin. Liedon kunnassa 1990-luvulla toteutettuun väestöpohjaiseen Liedon Iäkkäät -seurantatutkimukseen osallistui 1177 lietolaista 65 vuotta täyttänyttä. Lääkitystietoja sekä seuranta-aikana tapahtuneita murtumia analysoimalla havaittiin, että kahden tai useamman bentsodiatsepiinin sekä kahden tai useamman psykoosilääkkeen käyttö oli yhteydessä murtuman riskiin 65 vuotta täyttäneillä miehillä. Opioidin ja psykoosilääkkeen yhteiskäyttö sekä opioidin ja bentsodiatsepiinin yhteiskäyttö oli yhteydessä iäkkäiden miesten murtuman riskiin. Naisilla vastaavia tilastollisesti merkitseviä yhteyksiä ei havaittu. Väitöskirjatutkimuksen uusin osa-aineisto perustui Porissa vuosina 2009–2010 toteutetun Satauni-tutkimuksen aineistoon. Tutkimuksessa osoitettiin 89 potilaan aineistossa, että hallittu, yhden kuukauden aikana lääkärin ja hoitajan tuella toteutettu bentsodiatsepiinivieroitus paransi merkitsevästi 55 vuotta täyttäneiden naisten käden puristusvoimaa kuuden kuukauden seuranta-aikana. Vastaavaa yhteyttä ei havaittu miehillä. Bentsodiatsepiinivieroituksella ei ollut yhteyttä osallistujien tasapainotestin tulosten paranemiseen kuuden kuukauden seurantaaikana. Murtumilla on vakavia seurauksia sekä yksilötasolla että yhteiskunnallisesti iäkkäässä väestössä. Murtumien ehkäisy on hyvin tärkeää. Siinä tulee kiinnittää huomiota potilaan käyttämään lääkitykseen ja arvioida erityisesti usean hermostoon vaikuttavan lääkkeen yhteiskäytön tarpeellisuutta.

Planning and implementation of entrepreneurial marketing processes in SMEs

Entrepreneurial marketing is newly established term and there is need for more specific studies in order to understand the concept fully. SMEs have entrepreneurial marketing elements more visible in their marketing and therefore provide more fruitful insights for this research. SMEs marketing has gained more recognition during the past years and in some cases innovative characteristics can be identified despite constraints such as lack of certain resources. The purpose of this research is to study entrepreneurial marketing characteristics and SME processes in order to wider understanding and gain more insights of entrepreneurial marketing. In addition, planning and implementation of entrepreneurial marketing processes is examined in order to gain full coverage of SMEs marketing activities. The research was conducted as a qualitative research and data gathering was based on semi-structured interview survey, which involved nine company interviews. Multiple case research was used to analyze data so that focus and clarity could be maintained in organized manner. Case companies were chosen from different business fields so that more variation and insights could be identified. The empirical results suggest that two examined processes networking and word-of-mouth communication are very important processes for case companies which supports the previous researches. However, the entrepreneurial marketing characteristics had variation some were more visible and recognizable than others. Examining more closely the processes companies did not fully understand that networking or word-of-mouth marketing could be used as efficiently as other conventional marketing methods.

Value Creation in Crowd-Business: Developing a Framework for Successful Implementation of Crowdsourcing Initiatives

By recent years the phenomenon called crowdsourcing has been acknowledged as an innovative form of value creation that must be taken seriously. Crowdsourcing can be defined as an act of outsourcing tasks originally performed inside an organization, or assigned externally in form of a business relationship, to an undefinably large, heterogeneous mass of potential actors. This thesis constructs a framework for successful implementation of crowdsourcing initiatives. Firms that rely entirely on their own research and ideas cannot compete with the innovative capacity that crowd-powered firms have. Nowadays, crowdsourcing has become one of the key capabilities of businesses due to its innovative capabilities, in addition to the existing internal resources of the firm. By utilizing crowdsourcing the business gains access to an enormous pool of competence and knowledge. However, various risks remain such as uncertainty of crowd structure and loss of internal know-how. Crowdsourcing Success Framework introduces a step by step model for implementing crowdsourcing into the everyday operations of the business. It starts from the decision to utilize crowdsourcing and continues further into planning, organizing and execution. Finally, this thesis presents the success factors of crowdsourcing initiative.

Effect of trellising system on grape and wine composition of Syrah vines grown in the cerrado region of Minas Gerais

Based on the concept that the trellising system affects not only sunlight interception and carbon assimilation, but also the fruitzone microclimate, which has a great impact on fruit composition and consequently on wine quality, the effect of two trellising systems - Vertical Shoot Position (VSP) and modified Geneva Double Curtain (GDC) - on wine and berry composition of Syrah grapes grown in João Pinheiro, Northeast region of Minas Gerais State, Brazil was investigated. The parameters such as pH, berry size and weight, and seeds total phenolic contents were not affected by the training system. The GDC system produced fruits with the highest Brix and lowest titratable acidity. Berries from the VSP system presented lower anthocyanin concentration than those from the GDC system. Similar results were found for the total phenolic content of the skin of grape berries from the VSP system. GDC wines were characterized by high anthocyanin content and red color, resulting in wines with high color intensity. These data suggest that in the tropical region of Minas Gerais state, with high temperature and high sunlight intensity, the trellising system, which protects bunches against excessive radiation, should be chosen.

Effect of the implementation of the Hazard Analysis Critical Control Point (HACCP) prerequisite program in an institutional foodservice unit in Southern Brazil

The aims of this study were to investigate the hygienic practices in the food production of an institutional foodservice unit in Southern Brazil and to evaluate the effect of implementing good food handling practices and standard operational procedures using microbiological hygiene indicators. An initial survey of the general operating conditions classified the unit as regular in terms of compliance with State safety guidelines for food service establishments. An action plan that incorporated the correction of noncompliance issues and the training of food handlers in good food handling practices and standard operational procedures were then implemented. The results of the microbiological analysis of utensils, preparation surfaces, food handlers' hands, water, and ambient air were recorded before and after the implementation of the action plan. The results showed that the implementation of this type of practice leads to the production of safer foods.

Hygienic-sanitary working practices and implementation of a Hazard Analysis and Critical Control Point (HACCP) plan in lobster processing industries

This study aimed to verify the hygienic-sanitary working practices and to create and implement a Hazard Analysis Critical Control Point (HACCP) in two lobster processing industries in Pernambuco State, Brazil. The industries studied process frozen whole lobsters, frozen whole cooked lobsters, and frozen lobster tails for exportation. The application of the hygienic-sanitary checklist in the industries analyzed achieved conformity rates over 96% to the aspects evaluated. The use of the Hazard Analysis Critical Control Point (HACCP) plan resulted in the detection of two critical control points (CCPs) including the receiving and classification steps in the processing of frozen lobster and frozen lobster tails, and an additional critical control point (CCP) was detected during the cooking step of processing of the whole frozen cooked lobster. The proper implementation of the Hazard Analysis Critical Control Point (HACCP) plan in the lobster processing industries studied proved to be the safest and most cost-effective method to monitor each critical control point (CCP) hazards.

Implementation of Quantitative Reaction-based Model Refinement

Building a computational model for complex biological systems is an iterative process. It starts from an abstraction of the process and then incorporates more details regarding the specific biochemical reactions which results in the change of the model fit. Meanwhile, the model’s numerical properties such as its numerical fit and validation should be preserved. However, refitting the model after each refinement iteration is computationally expensive resource-wise. There is an alternative approach which ensures the model fit preservation without the need to refit the model after each refinement iteration. And this approach is known as quantitative model refinement. The aim of this thesis is to develop and implement a tool called ModelRef which does the quantitative model refinement automatically. It is both implemented as a stand-alone Java application and as one of Anduril framework components. ModelRef performs data refinement of a model and generates the results in two different well known formats (SBML and CPS formats). The development of this tool successfully reduces the time and resource needed and the errors generated as well by traditional reiteration of the whole model to perform the fitting procedure.

Analysis and guidelines for implementation of EN 1090-2 Standard to assist execution class assignment of steel structures

Finnish design and consulting companies are delivering robust and cost-efficient steel structures solutions to a large number of manufacturing companies worldwide. Recently introduced EN 1090-2 standard obliges these companies to specify the execution class of steel structures for their customers. This however, requires clarifying, understanding and interpreting the sophisticated procedure of execution class assignment. The objective of this research is to provide a clear explanation and guidance through the process of execution class assignment for a given steel structure and to support the implementation of EN 1090-2 standard in Rejlers Oy, one of Finnish design and consulting companies. This objective is accomplished by creating a guideline for designers that elaborates on the four-step process of the execution class assignment for a steel structure or its part. Steps one to three define the consequence class (projected consequences of structure failure), the service category (hazards associated with the service use exploitation of steel structure) and the production category (manufacturing process peculiarities), based on the ductility class (capacity of structure to withstand deformations) and the behaviour factor (corresponds to structure seismic behaviour). The final step is the execution class assignment taking into account results of previous steps. Main research method is indepth literature review of European standards family for steel structures. Other research approach is a series of interviews of Rejlers Oy representatives and its clients, results of which have been used to evaluate the level of EN 1090-2 awareness. Rejlers Oy will use the developed novel coherent standard implementation guideline to improve its services and to obtain greater customer satisfaction.