The effects of congestion in the daily management of a trauma hospital

Today’s healthcare organizations are under constant pressure for change, as hospitals should be able to offer their patients the best possible medical care with limited resources and, at the same time, to retain steady efficiency level in their operation. This is challenging, especially in trauma hospitals, in which the variation in the patient cases and volumes is relatively high. Furthermore, the trauma patient's care requires plenty of resources as most the patients have to be treated as single cases. Occasionally, the sudden increases in demand causes congestion in the operations of the hospital, which in Töölö hospital appears as an increase in the surgery waiting times within the yellow urgency class patients. An increase in the surgery waiting times may cause the diminution of the patient's condition, which also raises the surgery risks. The congestion itself causes overloading of the hospital capacity and staff. The aim of this master’s thesis is to introduce the factors contributing to the trauma process, and to examine the correlation between the different variables and the lengthened surgery waiting times. The results of this study are based on a three-year patient data and different quantitative analysis. Based on the analysis, a daily usable indicator was created in order to support the decision making in the operations management. By using the selected indicator, the effects of congestion can be acknowledged and the corrective action can also be taken more proactively.

Increased immunoglobulin production in silver catfish (Rhamdia quelen) exposed to agrichemicals

Fish vaccination has been increasingly exploited as a tool to control pathogen infection. The production of immunoglobulin following vaccination might be affected by several factors such as management procedures, water temperature, and the presence of xenobiotics. In the present study, we aimed to investigate the kinetics of immunoglobulin production in silver catfish (Rhamdia quelen) inoculated with inactivated Aeromonas hydrophila and kept at two different water temperatures (17.4±0.4° or 21.3±0.3°C). The effect of a second antigen inoculation and exposure of fish to sublethal concentrations of the herbicides atrazine and glyphosate at 10% of the lethal concentration (LC50-96h) on specific serum antibodies were also investigated. Antibodies to A. hydrophila were detected as early as 7 days post-inoculation and increased steadily up to 35 days. The kinetics of antibody production were similar in fish kept at 17.4±0.4° and 21.3±0.3°C, and reinoculation of antigen at 21 days after priming failed to increase specific antibody levels. Intriguingly, we found that, in fish exposed to atrazine and glyphosate, the secretion of specific antibodies was higher than in non-exposed inoculated fish. These findings are important for the design of vaccines and vaccination strategies in Neotropical fish species. However, because atrazine and glyphosate are widespread contaminants of soil and water, their immune-stimulating effect could be harmful, in that fish living in herbicide-contaminated water might have increased concentrations of nonspecific antibodies that could mediate tissue injury.

Microbiological and physicochemical evaluations of juice extracted from different parts of sugar cane stalks from three varieties cultivated under organic management

The artisanal production of cachaça, a beverage obtained by the fermentation of sugar cane juice after distillation, especially by small-sized producers, has traditionally used natural ferment ("fermento caipira") which consists of sugar cane juice with crushed corn, powdered rice, or citrus fruits. In despite of the difficulties in quality control due to the high level of contaminants and longer periods of preparation, the sensorial quality of the beverage may be attributed to the physiological activities of wild yeasts and even bacteria present during fermentation when this ferment is used. In this context, the aim here was to evaluate the microbiological (yeasts) and physicochemical characteristics of sugar cane juice extracted from different parts of three different varieties (RB72454, RB835486, and RB867515) of the cane stalk (lower, medium, and upper sections) in three harvesting periods (from May to December 2007) in an area under organic management. The juice from the upper section (from the eleventh internode to the top) of the sugar cane stalk could be indicated for the preparation of the natural ferment since it is as a source of yeasts and reducing sugars, especially the variety RB867515. Due to the seasonality, the best period for using this part of the sugar cane stalk is at the beginning of harvesting when the phenolic compounds are at low concentration, but there are higher number of Saccharomyces population and other yeast species. The high acidity in this section of the plant could result in a better control of bacterial contamination. These findings explain the traditional instructions of adding the upper sections for the preparation of natural ferment and can help its management in order to get a better performance with respect to organic cachaça production.

Project Charter, Scope, and Time Management In the Movie Industry

This thesis explores how the project charter development, project scope management, and project time management are executed in a Finnish movie production. The deviations and analogies between a case movie production and best practices suggested in PMBOK are presented. Empirical material from the case is gathered with two semi-structured interviews with a producer and a line producer. The interview data is categorized according to PMBOK knowledge areas. The analysis is complemented with movie industry specific norms found in popular movie production guides. The described and observed methods are linked together and the relationship between them is discussed. The project charter development, which is referred as a green light process in the movie industry, is mostly analogous between all areas. The deviations are in the level of formality. The green lighting in the case movie was accomplished without bureaucratic reports described in movie production guides. The empirical material shows that project management conventions and movie industry employ similar methods especially in scope management. Project management practices introduce a work breakdown structure (WBS) method, and movie production accomplishes the same task by developing a shooting script. Time management of the case movie deviates on most parts from the methods suggested in PMBOK. The major deviation is resource management. PMBOK suggests creating a resource breakdown structure. The case movie production accomplished this through budgeting process. Furthermore the popular movie production guides also disregard resource management as sovereign process. However the activity listing is quite analogous between the case movie and PMBOK. The final key observation is that although there is a broad set of effective and detailed movie industry specific methods, a comprehensive methodology that would cover the whole production process, such as Prince2 or Scrum, seems to be missing from the movie industry.

Management of freezing rate and trehalose concentration to improve frozen dough properties and bread quality

Abstract Bread is one of the most consumed foods in the world, and alternatives have been sought to extend its shell life, and freezing is one of the most popular methods. The purpose of this study was to evaluate the effect of freezing rate and trehalose concentration on the fermentative and viscoelastic properties of dough and bread quality. Dough was prepared and trehalose was added at three concentrations (0, 400, 800 ppm); dough was pre fermented and frozen at two freezing rates then stored for 42 days. Frozen dough samples were thawed every two weeks. CO2 production and elastic and viscous modulus were determined. In addition, bread was elaborated and specific volume and firmness were evaluated. High trehalose concentrations (400 and 800 ppm) produced dough with the best viscoelastic and fermentative properties. Greater bread volume and less firmness were observed when a slow freezing rate (-.14 °C/min) was employed.

Energy Management System for LVDC Island Networks

Recent developments in power electronics technology have made it possible to develop competitive and reliable low-voltage DC (LVDC) distribution networks. Further, islanded microgrids—isolated small-scale localized distribution networks— have been proposed to reliably supply power using distributed generations. However, islanded operations face many issues such as power quality, voltage regulation, network stability, and protection. In this thesis, an energy management system (EMS) that ensures efficient energy and power balancing and voltage regulation has been proposed for an LVDC island network utilizing solar panels for electricity production and lead-acid batteries for energy storage. The EMS uses the master/slave method with robust communication infrastructure to control the production, storage, and loads. The logical basis for the EMS operations has been established by proposing functionalities of the network components as well as by defining appropriate operation modes that encompass all situations. During loss-of-powersupply periods, load prioritizations and disconnections are employed to maintain the power supply to at least some loads. The proposed EMS ensures optimal energy balance in the network. A sizing method based on discrete-event simulations has also been proposed to obtain reliable capacities of the photovoltaic array and battery. In addition, an algorithm to determine the number of hours of electric power supply that can be guaranteed to the customers at any given location has been developed. The successful performances of all the proposed algorithms have been demonstrated by simulations.

Project charter, scope, and time management in the movie industry

This thesis explores how the project charter development, project scope management, and project time management are executed in a Finnish movie production. The deviations and analogies between a case movie production and best practices suggested in PMBOK are presented. Empirical material from the case is gathered with two semi-structured interviews with a producer and a line producer. The interview data is categorized according to PMBOK knowledge areas. The analysis is complemented with movie industry specific norms found in popular movie production guides. The described and observed methods are linked together and the relationship between them is discussed. The project charter development, which is referred as a green light process in the movie industry, is mostly analogous between all areas. The deviations are in the level of formality. The green lighting in the case movie was accomplished without bureaucratic reports described in movie production guides. The empirical material shows that project management conventions and movie industry employ similar methods especially in scope management. Project management practices introduce a work breakdown structure (WBS) method, and movie production accomplishes the same task by developing a shooting script. Time management of the case movie deviates on most parts from the methods suggested in PMBOK. The major deviation is resource management. PMBOK suggests creating a resource breakdown structure. The case movie production accomplished this through budgeting process. Furthermore the popular movie production guides also disregard resource management as sovereign process. However the activity listing is quite analogous between the case movie and PMBOK. The final key observation is that although there is a broad set of effective and detailed movie industry specific methods, a comprehensive methodology that would cover the whole production process, such as Prince2 or Scrum, seems to be missing from the movie industry.

Developing asset management in district heating and cooling business in a large energy company

The purpose of this Master´s Thesis is to develop asset management and its practices in case company. District heating and cooling systems operated by case company around Finland, Sweden, Poland and the Baltics form an enormous-sized asset base where some parts are starting to reach their end of life-cycles. Large-sized asset renewal actions are under discussion and maintenance spending is increasing. Financially justified decisions in changing business environment are needed. Asset management is one of the most important concepts for production organization which operates with capital-intensive production assets. Organizations profitability is highly dependent on assets´ performance. Such assets, like district heating and cooling systems, should be utilized as efficiently as possible within their life-cycles but also maintained and renewed optimally. In this qualitative thesis, empirical interview study was conducted to describe the current situation on how the assets are managed in the case company and to examine the readiness to implement a new, risk-based solution. Asset management revealed to be a very well-known concept. From proposed risk-based asset management point of view, several key observations were made. It was seen as a suitable solution, but further development will be needed. Based on the need and findings, several key processes and frameworks were created and also tested with a case study. Assets` condition monitoring should be improved, which would have a positive impact on event probability assessment. Risk acceptance is also a thing to be discussed further. When the evaluation becomes fluent in single investment cases, portfolio-level expansion should be considered and started. As a result, thesis proposes a solution how risk-based asset management could be performed practically in a capital-intensive case company in order to optimize the maintenance spending in a long run. Created practical framework is made universal: similar principles can be applied into multiple cases in case company but also in other energy companies. Risk-based asset management`s benefits could be utilized best in portfolio-level optimization where the capital would be invested to the most important objects from total risk point of view. Eventually, such approach would allow case company to optimize capital spending in a situation where funds are not adequate to cover all the mandatory needs and prioritization between the investment alternatives will truly be needed.

Developing Supply Chain Process Management and Measurement in Global Manufacturing Company

The objective of this research is to create a current state analysis of pulp supply chain processes from production planning to deliveries to customers. A cross-functional flowchart is being used to model these processes. These models help finding key performance indicators (KPIs) which enable examinations of the supply chain efficiency. Supply chain measures in different processes reveal the changes need processes that affect the whole supply chain and its efficiency and competitiveness. Structure of pulp supply chain differs from most of the other supply chains. The fact that there are big volumes of bulk products, small product variations and supply forecasts are made for the year ahead make the difference. This factor brings different benefits but also challenges when developing supply chain. This thesis divides pulp supply chain in three different main categories: production planning, warehousing and transportation. It provides tools for estimating the functionality of supply chain as well as developing the efficiency for different functions of supply chain. By having a better understanding of supply chain processes and measurement the whole supply chain structure can be developed significantly.

Offshoring and outsourcing under demand uncertainty -a supply chain management analysis

Outsourcing and offshoring or any combinations of these have not just become a popular phenomenon, but are viewed as one of the most important management strategies due to the new possibilities from globalization. They have been seen as a possibility to save costs and improve customer service. Executing offshoring and offshore outsourcing successfully can be more complex than initially expected. Potential cost savings resulting from of offshoring and offshore outsourcing are often based on lower manufacturing costs. However, these benefits might be conflicted by a more complex supply chain with service level challenges that can respectively increase costs. Therefore analyzing the total cost effects of offshoring and outsourcing is necessary. The aim of this Master´s Thesis was to to construct a total cost model using academic literature to calculate the total costs and analyze the reasonability of offshoring and offshore outsourcing production of a case company compared to insourcing production. The research data was mainly quantitative and collected mainly from the case company past sales and production records. In addition management level interviews from the case company were conducted. The information from these interviews was used for the qualification of the necessary quantitative data and adding supportive information that could not be gathered from the quantitative data. Both data collection and analysis were guided by a theoretical frame of reference that was based on academic literature concerning offshoring and outsourcing, statistical calculation of demand and total costs. The results confirm the theories that offshoring and offshore outsourcing would reduce total costs as both offshoring and offshore outsourcing options result in lower total annual costs than insourcing mainly due to lower manufacturing costs. However, increased demand uncertainty would make the alternative of offshore outsourcing more risky and difficult to manage. Therefore when assessing the overall impact of the alternatives, offshoring is the most preferable option. As the main cost savings in offshore outsourcing came from lower manufacturing costs, more specifically labour costs, the logistics costs in this case company did not have an essential effect in total costs. The management should therefore pay attention initially to manufacturing costs and then logistics costs when choosing the best production sourcing option for the company.

Development of a New Welding Product Quality Control and Management System Model for China

The Chinese welding industry is growing every year due to rapid development of the Chinese economy. Increasingly, companies around the world are looking to use Chinese enterprises as their cooperation partners. However, the Chinese welding industry also has its weaknesses, such as relatively low quality and weak management. A modern, advanced welding management system appropriate for local socio-economic conditions is required to enable Chinese enterprises to enhance further their business development. The thesis researches the design and implementation of a new welding quality management system for China. This new system is called ‗welding production quality control management model in China‘ (WQMC). Constructed on the basis of analysis of a survey and in-company interviews, the welding management system comprises the following different elements and perspectives: a ‗Localized congenital existing problem resolution strategies‘ (LCEPRS) database, a ‗human factor designed training system‘ (HFDT) training strategy, the theory of modular design, ISO 3834 requirements, total welding management (TWM), and lean manufacturing (LEAN) theory. The methods used in the research are literature review, questionnaires, interviews, and the author‘s model design experiences and observations, i.e. the approach is primarily qualitative and phenomenological. The thesis describes the design and implementation of a HFDT strategy in Chinese welding companies. Such training is an effective way to increase employees‘ awareness of quality and issues associated with quality assurance. The study identified widely existing problems in the Chinese welding industry and constructed a LCEPRS database that can be used in efforts to mitigate and avoid common problems. The work uses the theory of modular design, TWM and LEAN as tools for the implementation of the WQMC system.

Production under glass : working conditions and class-consciousness of the Niagara greenhouse workers

This study applies a Marxist theoretical paradigm to examine the working conditions of greenhouse workers in the Niagara Region, and the range of factors that bear upon the formation of their class-consciousness. The Niagara greenhouse industry represents one of the most developed horticultural regions in Canada and plays a prominent role in the local economy. The industry generates substantial revenues and employs a significant number of people, yet the greenhouse workers are paid one of the lowest rates in the region. Being classified as agricultural workers, the greenhouse employees are exempted from many provisions of federal and provincial labour regulations. Under the current provincial statutes, agricultural workers in Ontario are denied the right to organize and bargain collectively. Except for a few technical and managerial positions, the greenhouse industry employs mostly low-skilled workers who are subjected to poor working conditions that stem from the employer's attempts to adapt to larger structural imperatives of the capitalist economy. While subjected to these poor working conditions, the greenhouse workers are also affected by objectively alienated social relations and by ruling class ideological domination and hegemony. These two sets of factors arise from the inherent conflict of interests between wage-labour and capital but also militate against the development of class-consciousness. Semi-structured interviews were conducted with 12 greenhouse workers to examine the role played by their material circumstances in the formulation of their social and political views as well as the extent to which they are aware of their class location and class interests. The hegemonic notions of 'common sense' acted as impediments to formation of classconsciousness. The greenhouse workers have virtually no opportunities to access alternative perspectives that would address the issues associated with exploitation in production and offer solutions leading to 'social justice'. Fonnidable challenges confront any organized political body seeking to improve the conditions of the working people.

The Myth of Labour-Management Partnerships and the Risk to Labour: A CAMI Automotive Study

The purpose of this study is to examine and explore the level of risk that CAMI workers confront under their existing labour-management partnership arrangement. Risk is explored using two distinct categories, distributive and political. Distributive risk is expressed as tangibly substantive, reflecting the real terms and conditions of employment, and the changing social relations of production on the floor. The second type of risk is political and is concerned with the effects that labour-management partnerships have on the displacement of unions as legitimate agents of/for workers within the workplace. Data was collected using three methods; content analysis, cross-sectional survey and focus group interviews. The study revealed that CAMI workers are exposed to both distributive and political risk under their current LMP arrangement.

Insertion socioprofessionnelle des sortants de la formation agricole non formelle sur le marché de l’emploi au Burkina Faso et importance accordée à la production céréalière : cas des sortants du centre de promotion rurale de Goundi

L'étude combine les méthodes qualitative et qualitative à travers l’utilisation du questionnaire et du canevas d’entrevue. Elle s’appuie sur un cadre conceptuel élaboré à partir de revue de littérature et de concepts clefs tels que : le capital social, le capital humain, l’identité personnelle, l’identité professionnelle et la socialisation, Les résultats déterminent le profil d’un céréalier indiquant son attachement aux valeurs professionnelles liées au transfert de ses connaissances, à la modernisation de l’exploitation, à la recherche de l’amélioration du rendement et à l’utilisation d’outils modernes.

Droit du transport intermodal international de marchandises : une perspective « supply chain management ».

La thèse propose d’introduire une perspective globale dans le traitement juridique du transport intermodal international qui prendrait racine dans la stratégie logistique des entreprises. La conception juridique se heurte, en effet, aux évolutions opérationnelles et organisationnelles des transports et aboutit à une incertitude juridique. Les transporteurs ont dû s’adapter aux exigences d’optimisation des flux des chargeurs dont les modes de production et de distribution reposent sur le supply chain management (SCM). Ce concept est le fruit de la mondialisation et des technologies de l’information. La concurrence induite par la mondialisation et le pilotage optimal des flux ont impulsé de nouvelles stratégies de la part des entreprises qui tentent d’avoir un avantage concurrentiel sur le marché. Ces stratégies reposent sur l’intégration interfonctionnelle et interoganisationnelle. Dans cette chaîne logistique globale (ou SCM) l’intermodal est crucial. Il lie et coordonne les réseaux de production et de distribution spatialement désagrégés des entreprises et, répond aux exigences de maîtrise de l’espace et du temps, à moindre coût. Ainsi, le transporteur doit d’une part, intégrer les opérations de transport en optimisant les déplacements et, d’autre part, s’intégrer à la chaîne logistique du client en proposant des services de valeur ajoutée pour renforcer la compétitivité de la chaîne de valeur. Il en découle une unité technique et économique de la chaîne intermodale qui est pourtant, juridiquement fragmentée. Les Conventions internationales en vigueur ont été élaborées pour chaque mode de transport en faisant fi de l’interaction entre les modes et entre les opérateurs. L’intermodal est considéré comme une juxtaposition des modes et des régimes juridiques. Ce dépeçage juridique contraste avec la gestion de la chaîne intermodale dont les composantes individuelles s’effacent au profit de l’objectif global à atteindre. L’on expose d’abord l’ampleur de l’incertitude juridique due aux difficultés de circonscrire le champ d’opérations couvert par les Conventions en vigueur. Une attention est portée aux divergences d’interprétations qui débouchent sur la « désunification » du droit du transport. On s’intéresse ensuite aux interactions entre le transport et la chaîne logistique des chargeurs. Pour cela, on retrace l’évolution des modes de production et de distribution de ces derniers. C’est effectivement de la stratégie logistique que découle la conception de la chaîne intermodale. Partant de ce système, on identifie les caractéristiques fondamentales de l’intermodal. La thèse aboutit à dissiper les confusions liées à la qualification de l’intermodal et qui sont à la base des divergences d’interprétations et de l’incertitude juridique. De plus, elle met en exergue l’unité économique du contrat de transport intermodal qui devrait guider la fixation d’un régime de responsabilité dédié à ce système intégré de transport. Enfin, elle initie une approche ignorée des débats juridiques.