Sähköisten kuljetustietojen vaikutukset päivittäistavarakaupan pitkässä arvoketjussa

Tutkielman tavoitteena on esittää kustannustehokkaita tapoja lähetystoimintojen ja kuljetustietojen käsittelyyn päivittäistavarakaupan logistiikkakeskuksessa. Tutkielmassa kuvataan case-yrityksen lähettämö- ja kuljetustoimintojen sekä lähtevän tavaravirran seurannan ja rahtilaskutuksen nykytilanne. Tutkimusmenetelmänä on käytetty case-yrityksen avainhenkilöiden teemahaastatteluja sekä erillistä haastattelututkimusta kahdeksalle suurimmalle case-yrityksen käyttämälle kuljetusliikkeelle. Työssä esitellään keskeisimpien kuljetustietojen ja lähettämötoimintojen sähköistämisen edellytyksiä sekä niiden toteutusmahdollisuuksia. Koska lähtevän tavaravirran käsittely manuaalisesti aiheuttaa ylimääräisiä virheitä ja tehottomuutta pitkän arvoketjun eri vaiheissa työllistäen lähettämön, kuljetusliikkeiden, terminaalien ja myymälöiden työntekijöitä, on tutkielmassa esitelty keskeisimmät keinot tehostaa ja automatisoida lähtevien kuljetusyksiköiden käsittelyä. Ratkaisut pohjautuvat lähtevien kuljetusyksiköiden yksilöintiin ja seurantaan. Yksiköiden käsittelyä tehostetaan automatisoimalla yksiköiden tunnistamista ja tiedonsiirtoa. Käytettäviksi työkaluiksi on valittu viivakoodit ja tarvittavat lukijat yksiköiden tunnistamiseen. Sähköisellä rahtikirjalla pyritään paperittomaan lähettämötoimintaan ja sitä kautta automatisoimaan rahtilaskutusta ottamalla käyttöön laskuton maksu. Kuljetustietojen sähköistämisellä voidaan saavuttaa mittavat kustannussäästöt pitkässä arvoketjussa.

The Evolution of the European Regulatory Framework for Electronic Communications

The paper reviews the historical transformation of the European regulatory framework for electronic communications from the era dominated by state-owned enterprises to the presence of regulated competition. In the course of these developments, the vision of the roles of the public and private sectors in electronic communications changed in expected and unexpected ways. While the period is characterized by a shift toward less direct state intervention, the intensity of regulation has increased in many areas. Most recently, in the wake of the financial crisis, new forms of state intervention can be observed, including public investment in communications infrastructure and public-private partnerships. As a result of the reforms, Europe has been able to achieve major successes but it also suffered unanticipated setbacks compared to other regions. The European Union emerged as the global leader in mobile communications during the 1990s and was able to roll-out first-generation broadband access networks more rapidly than many of its peers. Recently, however, Europe as a whole has not performed as well in deploying next-generation networks and advanced mobile communications services. The paper offers a political-economic explanation for these developments and assesses their effects on the performance of the European electronic communications sector and the economy. From this analysis, the European model emerges as a unique institutional arrangement with peculiar advantages and disadvantages. Once these are recognized, sensible next steps to build the strengths while avoiding the weaknesses of the model can be seen more clearly.

Cigarette électronique : le point en 2015 [Electronic cigarette: what do we know in 2015?].

La cigarette électronique produit de la vapeur à inhaler contenant du propylène-glycol, des arômes et de la nicotine libérée rapidement. 6,7% de la population suisse, surtout des fumeurs, ont essayé la cigarette électronique et 0,1% l'utilise quotidiennement. Malgré l'incertitude due au bas niveau de preuves, la cigarette électronique pourrait être efficace pour cesser ou réduire le tabagisme. La sécurité de la cigarette électronique est démontrée à court terme mais pas à long terme ; sa toxicité semble très inférieure à celle du tabac. Les non-fumeurs et les jeunes utilisent peu la cigarette électronique qui ne semble pas les amener au tabagisme. Les mesures de santé publique recommandées sont la régulation du produit avec contrôle de la qualité ainsi que l'interdiction d'usage dans les lieux publics, de publicité et de vente aux mineurs. Electronic cigarettes are devices producing vapour containing propylene-glycol, flavourings and quickly delivered nicotine. 6.7% of the Swiss population, mainly smokers, experimented the electronic cigarette while 0.1% use it daily. Despite uncertainty due to the low level of evidence, electronic cigarettes might be effective for smoking cessation and reduction. The safety of electronic cigarettes is demonstrated at short-term but not at long-term; however its eventual toxicity is likely to be much lower than tobacco. Use of electronic cigarettes by non-smokers and youth who do not smoke is low and seems unlikely to lead them to tobacco use. Recommended public health measures include product regulation with quality control, ban in public places, prohibition of advertising and sales to minors.

Lésions induites par les pistolets à impulsion électrique de type Taser [Health Risks Concerning Electronic Control Devices]

Les pistolets à impulsion électrique (PIE) sont de plus en plus fréquemment utilisés en Europe ces dernières années, le modèle le plus connu étant le Taser®. Les connaissances scientifiques concernant les PIE et leurs effets potentiels restent toutefois limitées. Nous avons conduit une revue de littérature afin d'évaluer les implications potentielles de leur utilisation en termes de sécurité, de morbidité et de mortalité. Une exposition unique chez un individu sain peut généralement être considérée comme peu dangereuse. Les sujets à risque de complications sont les individus exposés à de multiples décharges, les personnes sous l'influence de substances psychoactives, ceux qui montrent des signes d'agitation extrême, ou encore les individus présentant des comorbidités médicales. L'éventail des complications pouvant survenir lors de leur exposition est large et inclut les lésions provoquées par les impacts des électrodes, les traumatismes liés à la chute induite par la paralysie transitoire ou des complications cardiovasculaires. Dans ce contexte, les personnes exposées doivent être examinées attentivement, et les éventuelles lésions traumatiques doivent être exclues. The use of electronic control devices (ECD), such as the Taser®, has increased in Europe over the past decade. However, scientific data concerning the potential health impact of ECD usage remains limited. We reviewed the scientific literature in order to evaluate the safety, mortality, and morbidity associated with ECD use. Exposure of a healthy individual to a single ECD electroshock can be considered generally safe. Complications can, however, occur if the patient is subject to multiple electroshocks, if the patient has significant medical comorbidities, or when exposure is associated with drug abuse or agitated delirium. The broad spectrum of potential complications associated with ECD exposure includes direct trauma caused by the ECD electrodes, injuries caused by the transient paralysis-induced fall, and cardiovascular events. An ECD-exposed patient requires careful examination during which traumatic injuries are actively sought out.

EEG as an Indicator of Cerebral Functioning in Postanoxic Coma.

Postanoxic coma after cardiac arrest is one of the most serious acute cerebral conditions and a frequent cause of admission to critical care units. Given substantial improvement of outcome over the recent years, a reliable and timely assessment of clinical evolution and prognosis is essential in this context, but may be challenging. In addition to the classic neurologic examination, EEG is increasingly emerging as an important tool to assess cerebral functions noninvasively. Although targeted temperature management and related sedation may delay clinical assessment, EEG provides accurate prognostic information in the early phase of coma. Here, the most frequently encountered EEG patterns in postanoxic coma are summarized and their relations with outcome prediction are discussed. This article also addresses the influence of targeted temperature management on brain signals and the implication of the evolution of EEG patterns over time. Finally, the article ends with a view of the future prospects for EEG in postanoxic management and prognostication.

Experts' consensus on use of electronic cigarettes : a Delphi survey from Switzerland

Objectifs: Dans certains pays, les cigarettes électroniques contenant de la nicotine (e-cigarettes) sont considérées comme des produits de consommation courante, sans régulation spécifique. Dans d'autres (comme en Suisse), la vente d'e-cigarettes contenant de la nicotine est interdite, malgré l'importante demande de nombreux fumeurs de pouvoir les obtenir. Au vu du manque de données scientifiques sur l'efficacité et la sécurité à long-terme de ces produits, les spécialistes de la lutte contre le tabagisme se trouvent divisés sur la question de leur régulation. Afin d'obtenir un consensus parmi ces experts que nous puissions transmettre aux autorités sanitaires, nous avons réalisé une étude d'avis d'experts sur le plan national. Méthode : Nous avons utilisé une méthodologie Delphi, à l'aide de questionnaires électroniques, afin de synthétiser l'opinion d'experts suisses sur la question de la cigarette électronique. Participants : 40 experts suisses représentant l'ensemble de la Suisse. Mesures : Nous avons mesuré le degré de consensus entre les experts au sujet de recommandations touchant à la régulation, la vente et l'utilisation de l'e-cigarette contenant de la nicotine, ainsi que leur opinion générale sur le produit. De nouvelles recommandations et déclarations ont été formulées en tenant compte des réponses et des commentaires des participants. Résultats : Un consensus entre les experts a établi que l'e-cigarette contenant de la nicotine devrait être accessible en Suisse, mais seulement dans des conditions spécifiques. La vente devrait être réservée aux adultes, en utilisant des standards de qualité, une limite de concentration maximale de nicotine, et être accompagnée d'une liste d'ingrédients autorisés. La publicité devrait être restreinte et l'utilisation de l'e- cigarette devrait être interdite dans les lieux publics. Conclusions : Ces recommandations permettent de regrouper trois principes : 1) le principe de réalité, étant donné que le produit est déjà disponible sur le marché ; 2) le principe de prévention, puisque l'e- cigarette procure une alternative au tabac pour les fumeurs actuels, et 3) le principe de précaution, afin de protéger les mineurs et les non-fumeurs, étant donné que les effets à long-terme ne sont pas encore connus. Les autorités suisses devraient mettre en place une législation spécifique afin d'autoriser l'e- cigarette contenant de la nicotine.

Heart Rate Variability (HRV) modifications in adult hemiplegic patients after botulinum toxin type A (nt-201) injection.

BACKGROUND: The most important adverse effect of BoNT-A is the systemic diffusion of the toxin. There is some evidence that the administration of high doses can increase the risk of systemic diffusion and the development of clinically evident adverse effects, however an international consensus does not exist about its maximum dose. AIM: The aim of this study was to evaluate changes in autonomic heart drive induced by high doses (higher than 600 units) of incobotulinumtoxinA injection in spastic stroke patients. Moreover, the treatment safety by monitoring adverse events occurrence was assessed. DESIGN: Case control study. POPULATION: Eleven stroke survivors with spastic hemiplegia. METHODS: Patients were treated with intramuscular focal injections of IncobotulinumtoxinA (NT 201; Xeomin®, Merz Pharmaceuticals GmbH, Frankfurt, Germany). Doses were below 12 units/Kg. Each patient underwent an ECG recording before injection and 10 days after treatment. Linear and non-linear Heart Rate variability (HRV) measures were derived from ECGs with a dedicated software. RESULTS: None of the variable considered showed statistically significant changes after BoNT-A injection. CONCLUSION: The use of incobotulinumtoxinA in adult patients at doses up to 12 units/kg seems to be safe regarding autonomic heart drive. CLINICAL REHABILITATION IMPACT: The use of IncobotulinumtoxinA up to 600 units could be a safe therapeutic option in spastic hemiplegic stroke survivors.

Modelling body mass index and endometrial cancer risk in a pooled-analysis of three case-control studies.

OBJECTIVE: To quantify the relation between body mass index (BMI) and endometrial cancer risk, and to describe the shape of such a relation. DESIGN: Pooled analysis of three hospital-based case-control studies. SETTING: Italy and Switzerland. POPULATION: A total of 1449 women with endometrial cancer and 3811 controls. METHODS: Multivariate odds ratios (OR) and 95% confidence intervals (95% CI) were obtained from logistic regression models. The shape of the relation was determined using a class of flexible regression models. MAIN OUTCOME MEASURE: The relation of BMI with endometrial cancer. RESULTS: Compared with women with BMI 18.5 to <25 kg/m(2) , the odds ratio was 5.73 (95% CI 4.28-7.68) for women with a BMI ≥35 kg/m(2) . The odds ratios were 1.10 (95% CI 1.09-1.12) and 1.63 (95% CI 1.52-1.75) respectively for an increment of BMI of 1 and 5 units. The relation was stronger in never-users of oral contraceptives (OR 3.35, 95% CI 2.78-4.03, for BMI ≥30 versus <25 kg/m(2) ) than in users (OR 1.22, 95% CI 0.56-2.67), and in women with diabetes (OR 8.10, 95% CI 4.10-16.01, for BMI ≥30 versus <25 kg/m(2) ) than in those without diabetes (OR 2.95, 95% CI 2.44-3.56). The relation was best fitted by a cubic model, although after the exclusion of the 5% upper and lower tails, it was best fitted by a linear model. CONCLUSIONS: The results of this study confirm a role of elevated BMI in the aetiology of endometrial cancer and suggest that the risk in obese women increases in a cubic nonlinear fashion. The relation was stronger in never-users of oral contraceptives and in women with diabetes. TWEETABLE ABSTRACT: Risk of endometrial cancer increases with elevated body weight in a cubic nonlinear fashion.

New technologies and nursing: use and perception of primary healthcare nurses about electronic health record in Catalonia, Spain

This study was aimed to analyze and assess the use and perception of electronic health records (EHRs) by nurses. The study sample included 113 nurses from different shifts of primary health facilities in Catalonia, Spain, devoted to adult as well as pediatric outpatients using EHRs throughout the year 2010. A majority of the sample (87.5%) were women and 12.5% were men. The average age was 44.27 years and the average time working in primary healthcare was 47.15 months. A majority (80.4%) received specific training on the use of the EHR and 19.6% did not. The use of the application required side technical support (mean: 3.42) and it is considered necessary to learn more about the performance of the application (mean: 3.50). The relationship between the average ratings that nurses have about the EHR and age shows that there is no statistically significant linear relationship (r = - 0.002, p-value = 0.984). As to how long they have used the EHRs, there are significant differences (r= -0.304, p-value = 0.00), so the more time the nurse takes using the EHR, the greater degree of satisfaction is shown. In addition, there are significant differences between nurses" perceptions regarding the EHR and gender (t = - 0.421, p-value = 0.675). Nurses assessed as positive the contribution of the EHRs in their nursing care day work (average score: 2.55/5). Considering that the usability of the EHR device is assessed as satisfactory, the results of the perception of nurses show that we must also take into account the training and emphasize the need for a side technical support in the implementation process of the EHR. Doing so, the positive perception that nurses have in regard to information and communication technology in general and with respect to the EHR in particular may be increased.

New technologies and nursing: use and perception of primary healthcare nurses about electronic health record in Catalonia, Spain

This study was aimed to analyze and assess the use and perception of electronic health records (EHRs) by nurses. The study sample included 113 nurses from different shifts of primary health facilities in Catalonia, Spain, devoted to adult as well as pediatric outpatients using EHRs throughout the year 2010. A majority of the sample (87.5%) were women and 12.5% were men. The average age was 44.27 years and the average time working in primary healthcare was 47.15 months. A majority (80.4%) received specific training on the use of the EHR and 19.6% did not. The use of the application required side technical support (mean: 3.42) and it is considered necessary to learn more about the performance of the application (mean: 3.50). The relationship between the average ratings that nurses have about the EHR and age shows that there is no statistically significant linear relationship (r = - 0.002, p-value = 0.984). As to how long they have used the EHRs, there are significant differences (r= -0.304, p-value = 0.00), so the more time the nurse takes using the EHR, the greater degree of satisfaction is shown. In addition, there are significant differences between nurses" perceptions regarding the EHR and gender (t = - 0.421, p-value = 0.675). Nurses assessed as positive the contribution of the EHRs in their nursing care day work (average score: 2.55/5). Considering that the usability of the EHR device is assessed as satisfactory, the results of the perception of nurses show that we must also take into account the training and emphasize the need for a side technical support in the implementation process of the EHR. Doing so, the positive perception that nurses have in regard to information and communication technology in general and with respect to the EHR in particular may be increased.

Enhancing actions of peptides derived from the γ-chain of fetal human hemoglobin on the immunostimulant activities of monophosphoryl lipid A.

Hemoglobin and its structures have been described since the 1990s to enhance a variety of biological activities of endotoxins (LPS) in a dose-dependent manner. To investigate the interaction processes in more detail, the system was extended by studying the interactions of newly designed peptides from the γ-chain of human hemoglobin with the adjuvant monophosphoryl lipid A (MPLA), a partial structure of lipid A lacking its 1-phosphate. It was found that some selected Hbg peptides, in particular two synthetic substructures designated Hbg32 and Hbg35, considerably increased the bioactivity of MPLA, which alone was only a weak activator of immune cells. These findings hold true for human mononuclar cells, monocytes and T lymphocytes. To understand the mechanisms of action in more detail, biophysical techniques were applied. These showed a peptide-induced change of the MPLA aggregate structure from multilamellar into a non-lamellar, probably inverted, cubic structure. Concomitantly, the peptides incorporated into the tightly packed MPLA aggregates into smaller units down to monomers. The fragmentation of the aggregates was an endothermic process, differing from a complex formation but rather typical for a catalytic reaction.