Sairaalan tarkkailuosaston hyödyt ja kustannukset

Työn tavoitteena oli tutkia Etelä-Karjalan keskussairaalaan mahdollisesti perustettavan yhdistelmätarkkailuosaston kannattavuutta määrittämällä osaston kustannukset ja hyödyt. Määritettyjen kustannusten avulla vertailtiin päivystys-potilaiden eri hoitoketjuvaihtoehtoja. Lähdeaineistona työssä käytettiin sairaalan omia materiaaleja ja tilastoja, henkilöstön haastatteluja sekä muita kirjallisuuslähteitä. Kirjallisuuden mukaan sairaalan ylikuormitus johtuu sen huonosta potilasvirtojen kulusta, jota voidaan parantaa joko toimintaa tehostamalla tai investoimalla uusiin resursseihin. Eräs vaihtoehto ylikuormituksen purkuun on tarkkailuosaston perustaminen, joka ei ole vain lisätila vaan potilasvirtojen ohjauskeino. Tehtyjen laskemien mukaan Etelä-Karjalan keskussairaalan tarkkailuosasto vaikuttaisi kannattavalta. Tarkkailuosaston kustannukset vuodessa olisivat 1 099 745 €, tuotot 1 170 108 € ja voitto 70 363 €. Osaston perustamiskustannukset olisivat 950 324 €. Hoitoketjujen potilaskohtaisen kannattavuuden mukaan päivystyspotilaiden tarkkailu ja lyhytaikainen hoito kannattaisi tehdä joko vuodeosastoilla tai tarkkailuosastolla, mutta ei tappiota tuottavalla ensiapupoliklinikalla. Tarkkailuosastosta olisi taloudellisten tekijöiden lisäksi myös muita hyötyjä ja haittoja sairaalan sidosryhmille. Sairaalan valitsemasta ylikuormituksen vähentämiskeinosta riippumatta, on sen tärkeätä aloittaa jo lähivuosina valmistautuminen väestön ikääntymisen aiheuttamaan lisääntyvään kuormitukseen.

CFD study of penetration and mixing of fuel in a circulating fluidized bed furnace

The aim of this thesis is to study the mixing of fuel and, also to some extent, the mixing of air in a circulating fluidized bed boiler. In the literature survey part of this thesis, a review is made of the previous experimental studies related to the fuel and air mixing in the circulating fluidized beds. In the simulation part of it the commercial computational fluid dynamics software (FLUENT) is used with the Eulerian multiphase model for studying the fuel mixing in the two and three-dimensional furnace geometries. The results of the three-dimensional simulations are promising and, therefore suggestions are made for the future simulations. The two-dimensional studies give new information of the effects of the fluidization velocity, fuel particle size and fuel density on the fuel mixing. However, the present results show that three-dimensional models produce more realistic representation of the circulating fluidized bed behavior.

Comparison of different methods to forecast hospital bed needs

Objectives : This study compares three methods to forecast the number of acute somatic hospital beds needed in a Swiss academic hospital over the period 2010-2030. Design : Information about inpatient stays is provided through a yearly mandatory reporting of Swiss hospitals, containing anonymized data. Forecast of the numbers of beds needed compares a basic scenario relying on population projections with two other methods in use in our country that integrate additional hypotheses on future trends in admission rates and length of stay (LOS).

Approach to the Lower Pliocene marine-continental correlation from southern Spain. The micrommamal site of Alhaurín el Grande-1 (Málaga Basin, Betic Cordillera, Spain)

A new micromammal site at Alhaurín el Grande (Málaga, southern Spain) located above early Pliocene marine deposits allows an approach to the marine-continental correlation for this age. The early Pliocene marine filling throughout the Málaga Basin is developed in three transgressive-regressive sequences (Pl-1, Pl-2, and Pl-3 units) bounded by discontinuities. At the top of the intermediate sequence Pl-2, peaty sediments have yielded fossils of Rodentia, Lagomorpha, Insectivora, and Crocodylia. The presence of Cricetus barrieri Mein & Michaux, 1970 in combination with murids, both of primitive morphology, such as Apodemus gudrunae Van de Weerd, 1976, and more advanced forms (i.e. Occitanomys brailloni Michaux, 1969 and Stephanomys donnezani cordii Ruiz Bustos, 1986), points to an early Ruscinian age (MN 14 biozone). Based on the planktonic foraminifers, the biostratigraphic data indicate that marine sediments just below the micromammal beds belong to the MPl-2 biozone of the early Zanclean. Available paleomagnetic data from the marine sediments show that the micromammal bed must be located between the normal geomagnetic subchron C3n3n (4.89-4.80 Ma) and the subchron C3n2n (4.63-4.49 Ma), limiting the age of this site to the late part of the early Zanclean.

Magnetoestratigrafía de las sucesiones del Mioceno medio y superior del Vallés occidental (Depresión del Vallés-Penedés, NE España): Implicaciones biocronológicas y cronoestratigráficas.

The magnetostratigraphic analysis of the middle to late Miocene continental deposits from the Valles-Penedes basin, combined with its well-documented fossil mammal record, provides a well-resoluted chronology for the upper basin infill. It is based on the biostratigraphic and magnetostratigraphic cross-correlation of 18 sections throughout the alluvial and transitional/shallow marine sequences in the Western Valles area. The biostratigraphic framework consists of 24 mammal localities of upper Aragonian and Vallesian age. Correlation of the studied sections to the geomagnetic polarity time scale (GPTS) is based on the distinctive pattern of local magnetozones, as well as the radiometric age of the late Vallesian fauna from the Bicorp Basin (9.6 + 0.3 Ma) and the known relationship of the late Vallesian assemblages with marine beds belonging to the planktonic forarninifera N16 zone. It has led to an absolute dating of the fauna1 events and a precise chronostratigraphy of the Vallesian marnrnal stage in its type area. The Hipparion First Appearance Datum (FAD) defines the lower Vallesian boundary and is dated at 11.1 Ma, at the base of chron C5r. ln. It is in good agreement with radiometric ages from the early Hipparion bearing sites in the Vienna Basin (1 1.1 * 0.5 Ma) and the classic Howenegg locality in Germany (10.8 * 0.3 Ma). It also agrees with the age of the turkish localities of Yailacilar (1 1.6 + 0.25 Ma) and Yenieskihisar-2 (1 1.1 * 0.2 Ma) with absence of Hipparion. Al1 these support the isochrony of the dispersa1 of Hipparion throughout the Mediterranean region. A possible isochrony at a larger geographical scale (Old World, Mesogea) must await more reliable ages of the Hipparion FAD in Asia and Africa. The Cricetulodon FAD that defines the MN9a/MN9b boundary occurs at the middle part of C5n. Assuming an on average constant sedimentation rate, this datum has an age of approximately 10.4 Ma. The earlyllate Vallesian boundary is marked by one of the most distinct fauna1 events of the late Neogene: the dispersa1 of the muridae Progonomys into Europe and North Africa, which coincides with an important macromarnmal turnover. The first extensive appearance of Progonomys in Europe (MN9íMN10 boundary) is dated at 9.7 Ma (C4Ar3r), showing a remarkable diachrony with the Himalayan region. F9i d lly, the FAD of Rotundomys bressnnus occurs in the upper part of C4Ar.ln (9.2-9.3 Ma). The Vallesian spans 2.4 Myr, from 11.1 Ma (CSr.ln) to 8.7 Ma (C4An), and correlates to the early Tortonian.

Teho-osaston ja valvontaosaston rakentamisen kannattavuus Oulun yliopistollisessa sairaalassa

Diplomityön tavoitteena oli määrittää Oulun yliopistollisen sairaalan Leikkaus- ja tehohoidon tulosyksikön teho- ja valvontaosaston paikkatarve sekä selvittää, miten sijainti vaikuttaa toimintaan, kun teho-osasto muuttaa kirurgian poliklinikan tiloihin ja sijainti muuttuu yhteispäivystysyksikköön, leikkausosastoon ja vuodeosastoihin nähden. Lisäksi selvitettiin, mihin uusi valvontaosasto kannattaa rakentaa sekä ra kentamishankkeen kannattavuus käyttämällä kolmea eri laskentamenetelmää. Työn teoria- ja empiriaosuus on osittain yhdistetty, mikä helpottaa työn seuraamista ja parantaa loogisuutta. Teoriaosuudessa käsitellään investointien kannattavuuden arviointia, poistojen vaikutusta talouteen, Pohjois-Pohjanmaan sairaanhoitopiiriä ja Leikkaus- ja tehohoidon tulosyksikön toimintaa sekä erityisesti tehohoitotyötä ja teho-osaston toimintaa. Empiriaosuus koostuu erityisvastuualueen väestönkehityksen arvioinnista, johon tulevaisuuden tehohoitotarve pohjautuu sekä teho- ja valvon taosaston paikkatarpeen määrityksestä ja investoinnin kannattavuuden arvioinnista. Työ antaa hyvän pohjan teho- ja valvontaosaston rakentamissuunnittelulle, ja investointien tarkastelu taloudelliselta näkökulmalta toimii tukena investointipäätöksenteolle. Tämän työn tuloksena teho- ja valvontaosaston rakentaminen on kannattavaa kolmen eri investointilaskelmamenetelmän perusteella.

Psychiatrie [New developments in psychiatry].

Three issues are discussed: i) While number of psychiatric beds has been reduced in most countries and although treatments proposed in psychiatric hospitals have evolved, they continue to be viewed as asylums implementing constraints. Considering this prevents their adequate use and leads to patients' stigmatisation, promotion of a better knowledge of contemporary hospital treatments is needed. 2) In addition, most psychiatric disorders emerging during adolescence and early adulthood, it is important to develop accessible care on university campuses. 3) While risk of weight gain and metabolic syndrome under neuroleptics or mood stabilisers is known, there is a need for the development of <red flags> that are easy to identify. A 5% increase in weight during the first month of treatment indicates the risk for important later weight gain.

Laitepuhdistamon ylijäämäliete ja sen kuiva-ainepitoisuuden nostaminen

Työssä tutkittiin pienpuhdistamon ylijäämälietteen ominaisuuksia ja käyttäytymistä pienpuhdistamon ylijäämälietteen tiivistys- tai kuivausmenetelmän kehittämisen teoriapohjaksi. Työ sisältää myös lietteiden tiivistysmenetelmien kustannustarkastelua. Kokeellisessa osuudessa käytettiin työn teettäjän Oy KWH Pipe Ab:n valmistamien pienpuhdistamojen ylijäämälietettä. Tutkittava ylijäämäliete oli peräisin asukasvastineluvultaan 5–95 pienistä aktiivilietelaitepuhdistamoista. Tiivistys- tai kuivausmenetelmän kehittämisen tarkoituksena on saavuttaa kustannussäästöjä pienpuhdistamon ylijäämälietteen kuljetusmatkojen vähentämisen kautta. Soveltuvia vertailtavia sovelluksia ovat staattiseen laskeuttamiseen perustuvat menetelmät, mekaaniset ruuvi- ja linkokuivaimet, kuivauslava ja flotaatio. Tarkasteltavien menetelmien tuli olla käytöltä ja huollolta sekä käyttökuluiltaan edullisia ja yksinkertaisia. Ylijäämälietteiden ominaisuuksia ja käyttäytymistä tutkittiin kirjallisuuslähteistä ja käytännön kokein. Kokeissa tarkasteltiin ylijäämälietteen laskeutumis- ja nousuominaisuuksia, redox-potentiaalin vaihtelua seisovassa näytteessä ja flotaation onnistumista testattavalle lietteelle. Kokeet tehtiin kullakin kerralla eri ajankohtana otetuille lietenäytteille, käytettyjä puhdistamoja oli useita ja mitoitus, kuormitus sekä jäteveden laatu vaihteli paljon.

Crassostrea patagonica (d'Orbigny, 1842) shell concentrations from the late Miocene Rio Negro province, NE Patagonia, Argentina

The Río Negro Formation (late Miocene-early Pliocene) mainly consists of continental deposits, but it contains a middle member of marine origin. It represents a transgressive-regressive sequence that can be seen at several outcrops along the N Patagonian coast. The taphonomical approach to the El Espigón marine deposits permits the identification of four main layers containing different kinds of skeletal accumulation, which mainly consist of oyster shells [Crassostrea patagonica (D'Orbigny, 1842)]. These concentrations display three different morphologies (pouches, pavements and bouquets) with a different taphonomic signature. These deposits were formed in shallow marine environments influenced by wave activity that produced valve concentrations of different entities. They contain several shell beds that represent event, composite, hiatal to lag skeletal concentrations. Traces of bioturbation in the sediment (Thalassinoides, Teichichnus) and bioerosion on the shells (Entobia, Gastrochaeonolites, Caulostrepsis), and encrusters (cirripeds, bryozoans), are also abundant in the outcrop and consititue common components of these Miocene materials. Layers 1 and 2 of the sequence were deposited in shoreface/foreshore environments at the beginning of a highstand systems tract, while layers 3 and 4 were deposited at the end, or at the beginning of a forced regression, in foreshore environments. A final erosional episode cut the top of the layer 4, which truncated the abundant bioturbaation developed there.

Distribuição de selênio em organismos marinhos da Baía de Guanabara/ RJ

The study assessed selenium concentrations in the muscle tissues and liver samples of three fish species and in the soft tissues of a mussel species. The samples were analyzed by GF-AAS using Zeeman background correction. Selenium in the muscle samples was higher in carnivorous fish. The liver of all studied fish species presented higher selenium concentrations than the muscle. The fish species presented a high positive correlation between their total length and selenium concentration. A significant correlation was observed between the selenium concentration in the mussel soft tissues and the condition index.

An experimental and theoretical study of multiphase flow in a circulating fluidized bed

A systematic averaging procedure has been derived in order to obtain an integral form of conservation equations for dispersed multiphase flow, especially applicable to fluidized beds. A similar averaging method is applied further to formulate macroscopic integral equations, which can be used in one-dimensional and macroscopic multi dimensional models. Circulating fluid bed hydrodynamics has been studied experimentally and both macroscopic and microscopic flow profiles have been measured in a cold model. As an application of the theory, the one dimensional model has been used to study mass and momentum conservation of gas and solid in a circulating fluid bed. Axial solid mixing has also been modelled by the one dimensional model and mixing parameters have been evaluated.

Deep-water macroalgal-dominated coastal detritic assemblages on the continental shelf off Mallorca and Menorca (Balearic Islands, Western Mediterranean)

We present a quantitative physiognomic characterization of major macroalgal-dominated assemblages on coastal detritic bottoms of the continental shelf off Mallorca and Menorca (Balearic Islands, Western Mediterranean). In late spring of 2007 and 2008, 29 samples were collected by bottom trawling at depths between -52 and -93 m. These samples were then sorted and identified to their lowest taxonomic level. Statistical analyses distinguished six different assemblage types: shallower water environments (-52 to -65 m in depth) were characterized by Osmundaria volubilis and Phyllophora crispa meadows and two types of Peyssonnelia beds; two assemblage types, Laminaria rodriguezii beds and maërl beds, were only present in deep-water environments (-77 to -81 m); and an assemblage dominated by P. crispa and Halopteris filicina was found in both shallow and deep waters (-57 to -93 m). We assess the distribution of these six assemblage types through the studied area.

Caracterização físico-química e microestrutural de conchas de moluscos bivalves provenientes de cultivos da região litorânea da ilha de Santa Catarina

Samples of shells of oysters and mussels from sea farm around the Santa Catarina Island in south Brazil were collected and analyzed by DRX, FRX, SEM, CHN-S, FTIR, TG, AAS/Flame and AAS /GF. The results showed that the crystalline structure of mussel's shells is mainly formed by aragonite and the oyster's shells by calcite. The calcium percentage in both shells species was in the range of 33 to 35% and also 850 and 1200 mg/kg of strontium was detected in the shells of oysters and mussels, respectively. The content of organic matter was larger in the mussel's shells and the thermal degradation of both shells species occurred by three events at different temperatures from 250 to 830 ºC.

Análise térmica aplicada à caracterização da sinvastatina em formulações farmacêuticas

Thermogravimetry (TG) and differential scanning calorimetry (DSC) are used in pharmaceutical studies for drugs characterization, purity, formulations compatibility, polymorphism identification, stability evaluation, and thermal decomposition of drugs and pharmaceutical formulations. Simvastatin showed fusion at 138.5 ºC and thermal stability up to 248 ºC. Simvastatin was incompatible with preservative excipient butylhydroxyanisole (BHA) performing a process of crystal amorphization. The drug showed morphological polymorphism, where it has the same unit cell but with different crystal habits according to the recrystallization solvent.

Comparação estrutural entre amostras de materiais tipo hidrotalcita obtidas a partir de diferentes rotas de síntese

Three samples of hydrotalcite-like materials (HTC) were synthesized and their structural characteristics were compared with two HTCs obtained commercially. Thermal analyses, FT-IR, PXRD and textural analyses were used to investigate the structural differences between commercial and synthetic samples. Particularly, the memory effect was observed at temperature higher than 600 ºC. The Rietveld refinements were obtained with expressive accuracy and the statistical parameters of goodness of fit are quite satisfactory. In conclusion, the procedures adopted in synthesis of HTC produced crystalline materials with high surface area materials.