Reliability of P-drive in occupational therapy following a short training session: A promising instrument measuring seniors' on-road driving competencies

Introduction Occupational therapists could play an important role in facilitating driving cessation for ageing drivers. This, however, requires an easy-to-learn, standardised on-road evaluation method. This study therefore investigates whether use of P-drive' could be reliably taught to occupational therapists via a short half-day training session. Method Using the English 26-item version of P-drive, two occupational therapists evaluated the driving ability of 24 home-dwelling drivers aged 70 years or over on a standardised on-road route. Experienced driving instructors' on-road, subjective evaluations were then compared with P-drive scores. Results Following a short half-day training session, P-drive was shown to have almost perfect between-rater reliability (ICC2,1=0.950, 95% CI 0.889 to 0.978). Reliability was stable across sessions including the training phase even if occupational therapists seemed to become slightly less severe in their ratings with experience. P-drive's score was related to the driving instructors' subjective evaluations of driving skills in a non-linear manner (R-2=0.445, p=0.021). Conclusion P-drive is a reliable instrument that can easily be taught to occupational therapists and implemented as a way of standardising the on-road driving test.

The potential of 3T high-resolution magnetic resonance imaging for diagnosis, staging, and follow-up of retinoblastoma.

We demonstrate the value of high-resolution magnetic resonance imaging (MRI) in diagnosing, staging, and follow-up of retinoblastoma during eye-saving treatment. We have included informative retinoblastoma cases scanned on a 3T MRI system from a retrospective retinoblastoma cohort from 2009 through 2013. We show that high-resolution MRI has the potential to detect small intraocular seeds, hemorrhage, and metastatic risk factors not visible with fundoscopy (e.g., optic nerve invasion and choroidal invasion), and treatment response. Unfortunately, however, the diagnostic accuracy of high-resolution MRI is not perfect, especially for subtle intraocular seeds or minimal postlaminar optic nerve invasion. The most important application of MRI is the detection of metastatic risk factors, as these cannot be found by fundoscopy and ultrasound.

Comparison between Radiographic (2-dimensional and 3-dimensional) and Histologic Findings of Periapical Lesions Treated with Apical Surgery.

INTRODUCTION: The aim of this study was to evaluate the concordance of 2- and 3-dimensional radiography and histopathology in the diagnosis of periapical lesions. METHODS: Patients were consecutively enrolled in this study provided that preoperative periapical radiography (PR) and cone-beam computed tomographic imaging of the tooth to be treated with apical surgery were performed. The periapical lesional tissue was histologically analyzed by 2 blinded examiners. The final histologic diagnosis was compared with the radiographic assessments of 4 blinded observers. The initial study material included 62 teeth in the same number of patients. RESULTS: Four lesions had to be excluded during processing, resulting in a final number of 58 evaluated cases (31 women and 27 men, mean age = 55 years). The final histologic diagnosis of the periapical lesions included 55 granulomas (94.8%) and 3 cysts (5.2%). Histologic analysis of the tissue samples from the apical lesions exhibited an almost perfect agreement between the 2 experienced investigators with an overall agreement of 94.83% (kappa = 0.8011). Radiographic assessment overestimated cysts by 28.4% (cone-beam computed tomographic imaging) and 20.7% (periapical radiography), respectively. Comparing the correlation of the radiographic diagnosis of 4 observers with the final histologic diagnosis, 2-dimensional (kappa = 0.104) and 3-dimensional imaging (kappa = 0.111) provided only minimum agreement. CONCLUSIONS: To establish a final diagnosis of an apical radiolucency, the tissue specimen should be evaluated histologically and specified as a granuloma (with/without epithelium) or a cyst. Analysis of 2-dimensional and 3-dimensional radiographic images alike results only in a tentative diagnosis that should be confirmed with biopsy.

Asiakkuuksien johtamisen kehittäminen, Tapaustutkimus

CRM eli Customer Relationship Management on muutaman vuoden ajan saanut osakseen merkittävästi huomiota yritysmaailmassa. Suurista lupauksista huolimatta CRM on aiheuttanut runsaasti pettymyksiä sen kehittämiseen ryhtyneissä yrityksissä. Tämän tutkimuksen tavoite on selvittää, miten CRM: a eli suomennettuna asiakkuuksien johtamista voidaan kehittää menestyksekkäästi tutkimuksen kohdeyrityksessä. Tähän pyritään laadullisin menetelmin toteutetulla tapaustutkimuksella hermeneuttista lähestymistapaa noudattaen. Asiakkuuksien johtaminen on prosessi, jossa organisaation vastuujaon, toiminta-prosessien ja teknologioiden muodostama kokonaisuus organisoidaan tukemaan asiakkuuslähtöistä strategiaa. CRM ei ole tietojärjestelmäprojekti eikä sitä voida koskaan kehittää lopullisen täydelliseksi, koska sen kokonaisuuden muodostavat osat kohtaavat jatkuvasti muutospaineita ympäristössään. Asiakkuuksien johtamista kehitettäessä tulee kohdeyrityksessä ensin muodostaa asiakkuuslähtöinen strategia ja tämän perusteella tarkistaa toimintojensa rooleja ja toimintaprosesseja ja viimeisenä kehittää näitä tukeva tietojärjestelmäkokonaisuus. Kehittämisen onnistumisen edellytyksiä kohdeyrityksen tapauksessa ovat erityisesti CRM- käsitteiden selventäminen, suunnittelun merkityksen ymmärtäminen, johdon tuen hankkiminen, puolueettoman hankkeen omistajan nimeäminen, muutosjohtaminen ja tietojärjestelmäkeskeisyyden hylkääminen. Tulokset saattavat olla suuntaa-antavasti sovellettavissa ainakin vastaavassa lähtötilanteessa oleviin muihinkin yrityksiin.

Platform Architectures for Policy-Based Network Access Control

Tämä diplomityö käsittelee sääntöpohjaisen verkkoon pääsyn hallinnan (NAC) ratkaisuja arkkitehtonisesta näkökulmasta. Työssä käydään läpi Trusted Computing Groupin, Microsoft Corporationin, Juniper Networksin sekä Cisco Systemsin NAC-ratkaisuja. NAC koostuu joukosta uusia sekä jo olemassa olevia teknologioita, jotka auttavat ennalta määriteltyyn sääntökantaan perustuen hallitsemaan suojattuun verkkoon pyrkivien laitteiden tietoliikenneyhteyksiä. Käyttäjän tunnistamisen lisäksi NAC pystyy rajoittamaan verkkoon pääsyä laitekohtaisten ominaisuuksien perusteella, esimerkiksi virustunnisteisiin ja käyttöjärjestelmäpäivityksiin liittyen ja paikkaamaan tietyin rajoituksin näissä esiintyviä puutteita verkkoon pääsyn sallimiseksi. NAC on verraten uusi käsite, jolta puuttuu tarkka määritelmä. Tästä johtuen nykymarkkinoilla myydään ominaisuuksiltaan puutteellisia tuotteita NAC-nimikkeellä. Standardointi eri valmistajien NAC-komponenttien yhteentoimivuuden takaamiseksi on meneillään, minkä perusteella ratkaisut voidaan jakaa joko avoimia standardeja tai valmistajakohtaisia standardeja noudattaviksi. Esitellyt NAC-ratkaisut noudattavat standardeja joko rajoitetusti tai eivät lainkaan. Mikään läpikäydyistä ratkaisuista ei ole täydellinen NAC, mutta Juniper Networksin ratkaisu nousee niistä potentiaalisimmaksi jatkokehityksen ja -tutkimuksen kohteeksi TietoEnator Processing & Networks Oy:lle. Eräs keskeinen ongelma NAC-konseptissa on työaseman tietoverkolle toimittama mahdollisesti valheellinen tietoturvatarkistuksen tulos, minkä perusteella pääsyä osittain hallitaan. Muun muassa tähän ongelmaan ratkaisuna voisi olla jo nykytietokoneista löytyvä TPM-siru, mikä takaa tiedon oikeellisuuden ja koskemattomuuden.

One-seller assignment markets with multi-unit demands

We consider one-seller assignment markets with multi-unit demands and prove that the associated game is buyers-submodular. Therefore the core is non-empty and it has a lattice structure which contains the allocation where every buyer receives his marginal contribution. We prove that in this kind of market, every pairwise-stable outcome is associated to a competitive equilibrium and viceversa. We study conditions under which the buyers-optimal and the seller-optimal core allocations are competitive equilibrium payoff vectors. Moreover, we characterize the markets for which the core coincidences with the set of competitive equilibria payoff vectors. When agents behave strategically, we introduce a procedure that implements the buyers-optimal core allocation as the unique subgame perfect Nash equilibrium outcome.

Anatomy of liver arteries for interventional radiology.

The availability of intra-arterial hepatic therapies (radio and/or chemo-embolisation, intra-arterial hepatic chemotherapy) has convinced radiologists to perfect their knowledge of the anatomy of the liver arteries. These sometimes, complex procedures most often require selective arterial catheterization. Knowledge of the different arteries in the liver and the peripheral organs is therefore essential to optimize the procedure and avoid eventual complications. This paper aims to describe the anatomy of the liver arteries and the variants, applying it to angiography images, and to understand the implications of such variations in interventional radiological procedures.

A Legislator under Surveillance: The Creation and Implementation of Swiss Banking Legislation 1910-1934

This paper analyses how banking regulation was introduced in Switzerland - one of the world's most prominent financial centres - which remained in place until the beginning of the twenty-first century. It shows that the law adopted on 8 November 1934 is a perfect example of capture of the regulator by the regulated. Essentially a political response in the context of the economic crisis of the 1930s, it largely reflected the interests of banking circles by limiting the intervention of the State as much as possible. The introduction of the new legislation was facilitated by the temporary weakness of Swiss banking circles, as they depended on the State to delay or prevent the collapse of many major credit institutions. They did not manage to derail the law as they had two decades earlier when they scuppered the federal bill on banks drawn up between 1914 and 1916. But this time they were better organized and more united, and intervened all the more effectively in the legislative process itself. The 1934 law is thus distinctive in that it made no structural changes to the architecture of the financial centre but merely codified its practices through flexible legislation meant to reassure the public. The law was aimed less at controlling banking activity than at keeping - thanks to skilfully calibrated political concessions - the State from having to intervene more directly in the internal management of banks or in the fixing of interest rates and the export of capital.

Palveluiden hinnoittelumallit

Tässä työssä kuvataan erilaisia malleja palveluiden hinnoitteluun. Työn tavoitteena on saada kokonaiskuva erilaisista palveluiden hinnoittelumalleista. Lähtökohtana ovat palveluiden, hinnan, hinnoittelun ja kustannusten määritelmät. Malleista kuvataan hinnoittelun peruste, yleisiä käyttökohteita sekä vahvuuksia ja heikkouksia. Eri mallit on jaettu kahteen osaan. Yrityskohtaiset mallit kuvaavat laajasti hinnoitteluprosessia. Yksityiskohtaisemmat palvelukohtaiset mallit on jaettu resurssi-, tuotos-, käyttöoikeus- ja käyttöperusteisiin, sekä hyöty- ja arvoperusteisiin menetelmiin. Täydellistä kaikille palveluille sopivaa hinnoittelumenetelmää ei ole. Jokaisessa mallissa on heikkouksia ja vahvuuksia. Eri menetelmät soveltuvat erilaisiin tilanteisiin ja niitä käytetään yrityksissä usein rinnakkain niin sanottuina hybridimalleina. Lisäksi palveluiden hinnoitteluun liittyy yllättävän paljon intuitiota ja kokemuksellista tietoa.

Measurement Properties of the Smartphone-Based B-B Score in Current Shoulder Pathologies.

NlmCategory="UNASSIGNED">This study is aimed at the determination of the measurement properties of the shoulder function B-B Score measured with a smartphone. This score measures the symmetry between sides of a power-related metric for two selected movements, with 100% representing perfect symmetry. Twenty healthy participants, 20 patients with rotator cuff conditions, 23 with fractures, 22 with capsulitis, and 23 with shoulder instabilities were measured twice across a six-month interval using the B-B Score and shoulder function questionnaires. The discriminative power, responsiveness, diagnostic power, concurrent validity, minimal detectable change (MDC), minimal clinically important improvement (MCII), and patient acceptable symptom state (PASS) were evaluated. Significant differences with the control group and significant baseline-six-month differences were found for the rotator cuff condition, fracture, and capsulitis patient groups. The B-B Score was responsive and demonstrated excellent diagnostic power, except for shoulder instability. The correlations with clinical scores were generally moderate to high, but lower for instability. The MDC was 18.1%, the MCII was 25.2%, and the PASS was 77.6. No floor effect was observed. The B-B Score demonstrated excellent measurement properties in populations with rotator cuff conditions, proximal humerus fractures, and capsulitis, and can thus be used as a routine test to evaluate those patients.

Proportionality and Party Success in Europe

This thesis consists of four articles and an introductory section. The main research questions in all the articles are about proportionality and party success in Europe, at European, national or district levels. Proportionality in this thesis denotes the proximity of seat shares parties receive compared to their respective vote shares, after the electoral system’s allocation process. This proportionality can be measured through numerous indices that illustrate either the overall proportionality of an electoral system or a particular election. The correspondence of a single party’s seat shares to its vote shares can also be measured. The overall proportionality is essential in three of the articles (1, 2 and 4), where the system’s performance is studied by means of plots. In article 3, minority party success is measured by advantage-ratios that reveal single party’s winnings or losses in the votes to seat allocation process. The first article asks how proportional are the European parliamentary (EP) electoral systems, how do they compare with results gained from earlier studies and how do the EP electoral systems treat different sized parties. The reasons for different outcomes are looked for in explanations given by traditional electoral studies i.e. electoral system variables. The countries studied (EU15) apply electoral systems that vary in many important aspects, even though a certain amount of uniformity has been aspired to for decades. Since the electoral systems of the EP elections closely resemble the national elections, the same kinds of profiles emerge as in the national elections. The electoral systems indeed treat the parties differentially and six different profile types can be found. The counting method seems to somewhat determine the profile group, but the strongest variables determining the shape of a countries’ profile appears to be the average district magnitude and number of seats allocated to each country. The second article also focuses on overall proportionality performance of an electoral system, but here the focus is on the impact of electoral system changes. I have developed a new method of visualizing some previously used indices and some new indices for this purpose. The aim is to draw a comparable picture of these electoral systems’ changes and their effects. The cases, which illustrate this method, are four elections systems, where a change has occurred in one of the system variables, while the rest remained unchanged. The studied cases include the French, Greek and British European parliamentary systems and the Swedish national parliamentary system. The changed variables are electoral type (plurality changed to PR in the UK), magnitude (France splitting the nationwide district into eight smaller districts), legal threshold (Greece introducing a three percent threshold) and counting method (d’Hondt was changed to modified Sainte-Laguë in Sweden). The radar plots from elections after and before the changes are drawn for all country cases. When quantifying the change, the change in the plots area that is created has also been calculated. Using these radar plots we can observe that the change in electoral system type, magnitude, and also to some extent legal threshold had an effect on overall proportionality and accessibility for small parties, while the change between the two highest averages counting method had none. The third article studies the success minority parties have had in nine electoral systems in European heterogeneous countries. This article aims to add more motivation as to why we should care how different sized parties are treated by the electoral systems. Since many of the parties that aspire to represent minorities in European countries are small, the possibilities for small parties are highlighted. The theory of consociational (or power-sharing) democracy suggests that, in heterogeneous societies, a proportional electoral system will provide the fairest treatment of minority parties. The OSCE Lund Recommendations propose a number of electoral system features, which would improve minority representation. In this article some party variables, namely the unity of the minority parties and the geographical concentration of the minorities were included among possible explanations. The conclusions are that the central points affecting minority success were indeed these non-electoral system variables rather than the electoral system itself. Moreover, the size of the party was a major factor governing success in all the systems investigated; large parties benefited in all the studied electoral systems. In the fourth article the proportionality profiles are again applied, but this time to district level results in Finnish parliamentary elections. The level of proportionality distortion is also studied by way of indices. The average magnitudes during the studied periodrange from 7.5 to 26.2 in the Finnish electoral districts and this opens up unequal opportunities for parties in different districts and affects the shape of the profiles. The intra-country case allows the focus to be placed on the effect of district magnitude, since all other electoral systems are kept constant in an intra-country study. The time span in the study is from 1962 to 2007, i.e. the time that the districts have largely been the same geographically. The plots and indices tell the same story, district magnitude and electoral alliances matter. The district magnitude is connected to the overall proportionality of the electoral districts according to both indices, and the profiles are, as expected, also closer to perfect proportionality in large districts. Alliances have helped some small parties to gain a much higher seat share than their respective vote share and these successes affect some of the profiles. The profiles also show a consistent pattern of benefits for the small parties who ally with the larger parties.

Täydellinen esimies - case Lomaliitto

Tämän tutkimuksen päätarkoituksena oli löytää esimiestyön kehitettävät osa-alueet Lomaliiton valituissa toimipaikoissa alaisen näkökulmasta. Osa päätarkoitusta oli myös tarjota Lomaliitolle työkalut esimiestyön kehittämistarpeiden tunnistamiseen tulevaisuudessa. Lisäksi tutkimuksen tarkoituksena oli osallistua akateemiseen keskusteluun, jossa pyritään selvittämään täydellistä johtamista. Tutkimuksen päätarkoitukseen päästiin erilaisten tavoitteiden kautta käyttäen apuna sähköistä kyselyä, jolla saatiin sekä kvantitatiivista että kvalitatiivista aineistoa. Ensimmäinen tavoite oli selvittää mitä esimiehen ominaisuuksia alaiset arvostavat. Toinen tavoite oli selvittää mikä on alaisten mielestä hyvää ja huonoa esimiesten johtamisessa. Kolmas tavoite oli selvittää eroavatko alaisten arviot esimiestensä johtamisesta osastoittain, hierarkiatasoittain, sukupuolittain ja ikäluokittain tarkasteltuna. Viimeisenä tavoitteena oli selvittää eroavatko esimiesten ja alaisten arviot esimiesten johtamisesta toisistaan. Tutkimuksessa selvisi esimiehen tärkeimmät ominaisuudet, joita alaiset arvostavat. Keskimäärin alaiset arvioivat johtamisen tyydyttäväksi Lomaliiton tutkimukseen valituissa toimipaikoissa. Toimipaikkojen välillä esimiesten alaisiltaan saamat arviot ja kehitettävät ominaisuudet vaihtelivat jonkin verran. Se millaiseksi johtaminen arvioitiin, vaihteli jonkin verran myös osastoittain. Sen sijaan esimiesten saamat arviot alaisen hierarkiatason, sukupuolen ja ikäryhmän mukaan eivät kuitenkaan eronneet kovinkaan paljoa. Merkittävä ero löytyi kuitenkin vertaamalla esimiesten arvioita näiden alaisten arvioihin heidän johtamisestaan.

Generalization transitions in Hidden-Layer neural networks for third-order feature discrimination

Stochastic learning processes for a specific feature detector are studied. This technique is applied to nonsmooth multilayer neural networks requested to perform a discrimination task of order 3 based on the ssT-block¿ssC-block problem. Our system proves to be capable of achieving perfect generalization, after presenting finite numbers of examples, by undergoing a phase transition. The corresponding annealed theory, which involves the Ising model under external field, shows good agreement with Monte Carlo simulations.

Incidental enchondromas at knee magnetic resonance imaging: intraobserver and interobserver agreement and prevalence of imaging findings

Objective To evaluate intra- and interobserver agreement in the identification of incidental enchondromas at knee magnetic resonance imaging, and to assess the prevalence of imaging findings. Materials and Methods Retrospective study reviewing 326 knee magnetic resonance images acquired in the period between November 2009 and September 2010. The images were independently and blindly analyzed by two specialists in musculoskeletal radiology, with the objective of identifying incidental enchondromas, presence of foci with signal similar to bone marrow and foci of signal absence suggestive of calcifications within the enchondromas. Inter- and intraobserver agreements were analyzed. Results Eleven lesions compatible with enchondromas (3.3%) were identified. The interobserver agreement for the presence of enchondroma was high. Prevalence of foci of bone marrow signal inside the enchondromas was of 54.55%, and foci suggestive of calcification corresponded to 36.36%. The intraobserver agreement for foci of bone marrow signal in enchondromas was perfect, and interobserver agreement was high. Conclusion The prevalence of incidental enchondromas in the current study was compatible with data in the literature. Excellent agreement was observed in the identification of enchondromas and in the assessment of imaging findings. A higher prevalence of fat signal foci was observed as compared with signal absence suggestive of calcifications.

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.