Financial performance of segments in the intelligent home network

The goal of this study is to examine the intelligent home business network in order to determine which part of the network has the best financial abilities to produce new business models and products/services by using financial statement analysis. A group of 377 studied limited companies is divided into four examined segments based on their offering in producing intelligent homes. The segments are customer service providers, system integrators, subsystem suppliers and component suppliers. Eight different key figures are calculated from each of the companies to get a comprehensive view of their financial performances, after which each of the segments is studied statistically to determine the performances of the whole segments. The actual performance differences between the segments are calculated by using the multi-criteria decision analysis method in which the performances of the key figures are graded and each key figure is weighted according to its importance for the goal of the study. The results of this analysis showed that subsystem suppliers have the best financial performance. Second best are system integrators, third are customer service providers and fourth component suppliers. None of the segments were strikingly poor, but even component suppliers were rather reasonable in their performance; so, it can be said that no part of the intelligent home business network has remarkably inadequate financial abilities to develop new business models and products/services.

Democracy begins at home : parenting, empathy, and adolescents' support for democratic values

Bakgrund Demokratiska samhällen är sårbara och historiskt sett sällsynta. Förutsättningarna för en fungerande demokrati innefattar mer än formella institutioner eller enbart frånvaron av diktatorer och extremgrupper. För att en regim skall fungera enligt demokratiska principer behövs medborgare som stöder demokratiska värden. Därför är det av vikt att förstå de processer som får individer att känna tilltro till demokratiska värden. Trots att man kan anta att stöd för sådana värderingar utvecklas som ett resultat av social inlärning är de konkreta omständigheterna som leder till ett dylikt lärande mindre uppenbara. Den klassiska litteraturen beträffande politisk socialisation lyfte fram föräldrarna som avgörande för de ungas medborgerliga fostran, men i moderna samhällen har föräldrarna sällan som en uttalad målsättning att försöka påverka sina barns nuvarande eller framtida politiska preferenser. Den föreliggande studiens mål var att fördjupa diskursen kring politisk socialisation gen om att analysera föräldraskapets betydelse för demokratiska värderingar hos ungdomar. Metod Den föreliggande studien utgick från två slumpmässiga urval. Det ena omfattade 1341 studerande, 17 år gamla, inom andra stadiets utbildning i tre regioner i Finland (södra, syd-västra och västra) och det andra 678 studerande, 16 år gamla vid studiens inledande, från den flamländska delen av Belgien. Studien innefattade frågeformulär som besvarades under skoltid. Resultat De centrala resultaten från studien kan sammanfattas i fyra punkter. För det första kunde empatiskt tänkande konstateras vara en god förklarande variabel för ungdomars demokratiska värderingar (Artikel 1). För det andra gav studien stöd för antagandet att stödjande föräldraskap är av betydelse för utvecklingen av empati under ungdomsåren (Artikel 2). För det tredje utvärderades empati, i relation till andra betydelsefulla variabler, som förklarande variabel för demokratiska värderingar (Artikel 3). För det fjärde gav den föreliggande studien bevis för att demokratiskt föräldraskap, både direkt och indirekt, är relaterat till demokratiska värderingar hos ungdomar. Sammanfattning Sammanfattningsvis visade den föreliggande studien hur föräldraskap både direkt och indirekt kan påverka demokratiska värderingar hos ungdomar och hur dessa resultat kunde användas för demokratisk samhällsfostran.

Cognitive Development of Very Low Birth Weight Children from Infancy to Pre-school Age

The survival of preterm born infants has increased but the prevalence of long-term morbidities has still remained high. Preterm born children are at an increased risk for various developmental impairments including both severe neurological deficits as well as deficits in cognitive development. According to the literature the developmental outcome perspective differs between countries, centers, and eras. Definitions of preterm infant vary between studies, and the follow-up has been carried out with diverse methods making the comparison less reliable. It is essential to offer parents upto-date information about the outcome of preterm infants born in the same area. A centralized follow-up of children at risk makes it possible to monitor the consequences of changes in the treatment practices of hospitals on developmental outcome. This thesis is part of a larger regional, prospective multidisciplinary follow-up project entitled “Development and Functioning of Very Low Birth Weight Infants from Infancy to School Age” (PIeniPAinoisten RIskilasten käyttäytyminen ja toimintakyky imeväisiästä kouluikään, PIPARI). The thesis consists of four original studies that present data of very low birth weight (VLBW) infants born between 2001 and 2006, who are followed up from the neonatal period until the age of five years. The main outcome measure was cognitive development and secondary outcomes were significant neurological deficits (cerebral palsy, CP, deafness, and blindness). In Study I, the early crying and fussing behavior of preterm infants was studied using parental diaries, and the relation of crying behavior and cognitive and motor development at the age of two years was assessed. In Study II, the developmental outcome (cognitive, CP, deafness, and blindness) at the age of two years was studied in relation to demographic, antenatal, neonatal, and brain imaging data. Development was studied in relationship to a full-term born control group born in the same hospital. In Study III, the stability of cognitive development was studied in VLBW and full-term groups by comparing the outcomes at the ages of two and five years. Finally, in Study IV the precursors of reading skills (phonological processing, rapid automatized naming, and letter knowledge) were assessed for VLBW and full-term children at the age of five years. Pre-reading skills were studied in relation to demographic, antenatal, neonatal, and brain imaging data. The main findings of the thesis were that VLBW infants who fussed or cried more in the infancy were not at greater risk for problems in their cognitive development. However, crying was associated with poorer motor development. The developmental outcome of the present population was better that has been reported earlier and this improvement covered also cognitive development. However, the difference to fullterm born peers was still significant. Major brain pathology and intestinal perforation were independent significant risk factors for adverse outcome, also when several individual risk factors were controlled for. Cognitive development at the age of two years was strongly related with development at the age of five years, stressing the importance of the early assessment, and the possibility for early interventions. Finally, VLBW children had poorer pre-reading skills compared with their full-term born peers, but the IQ was an important mediator even when children with mental retardation were excluded from the analysis. The findings suggest that counseling parents about the developmental perspectives of their preterm infant should be based on data covering the same birth hospital. Neonatal brain imaging data and neonatal morbidity are important predictors for developmental outcome. The findings of the present study stress the importance of both short-term (two years) and long-term (five years) follow-ups for the individual, and for improving the quality of care.

Private Home Care in Municipal Service Systems – A Case Study among Finnish and Swedish Municipalities

The aim of this study is to assess the current and future preconditions for conducting private business in municipal service systems for home care in Lahti and Hyvinkää in Finland, and in Uppsala and Huddinge in Sweden. This study also aims to assess the implications of quality related issues on the preconditions for conducting private business in the service systems in question. The theories and the research methodologies of the study are based on the Business Model Generation and the Business Model Canvas -concepts. Also a couple of frameworks on implications of quality are applied and integrated into the study. The study is completed as a case study – with structured and identical approaches for all four municipalities. The analyses and assessments of the study are primarily qualitative, but supported by simple quantitative methodologies. The data of the study consists primarily of publicly available information, and secondarily of answers provided by the case-municipalities to multiple choice questions. The results of the study show that the service systems for home care among the case-municipalities are, from perspective of private companies, diverse with local characteristics. Both the premises for conducting private business and the quality-issues are in many respects different in the Finnish and the Swedish case-municipalities. This is partly due to differences in the national service systems; the service voucher system versus the system of choice. Still, it appears that the current preconditions for conducting private business in the service systems for home care, including the implications of quality, would be more favorable in Uppsala and Huddinge than in Lahti and Hyvinkää. On the other hand, the service systems are subject to changes, and the most positive and significant development is here forecasted for a Finnish case-municipality (Lahti). Communication of quality is clearly more advanced in the Swedish case-municipalities. The results of this study can be utilized in several ways, for instance by private companies interested in entering into service systems for home care, either in some of the case-municipalities, or in some other Finnish or Swedish municipalities. Also municipalities can apply the analyses of the study when designing, developing or evaluating their own service systems for home care.

Obstetric outcomes in the second birth of women with a previous caesarean delivery: a retrospective cohort study from Peru

PURPOSE: To examine obstetric outcomes in the second birth of women who had undergone a previous cesarean delivery. METHODS: This was a large hospital-based retrospective cohort study. We included pregnant women who had a previous delivery (vaginal or cesarean) attending their second birth from 2001 to 2009. Main inclusion criteria were singleton pregnancies and delivery between a gestation of 24 and 41 weeks. Two cohorts were selected, being women with a previous cesarean delivery (n=7,215) and those with a vaginal one (n=23,720). Both groups were compared and logistic regression was performed to adjust for confounding variables. The obstetric outcomes included uterine rupture, placenta previa, and placental-related complications such as placental abruption, preeclampsia, and spontaneous preterm delivery. RESULTS: Women with previous cesarean delivery were more likely to have adverse outcomes such as uterine rupture (OR=12.4, 95%CI 6.8-22.3), placental abruption (OR=1.4, 95%CI 1.1-2.1), preeclampsia (OR=1.4, 95%CI 1.2-1.6), and spontaneous preterm delivery (OR=1.4, 95%CI 1.1-1.7). CONCLUSIONS: Individuals with previous cesarean section have adverse obstetric outcomes in the subsequent pregnancy, including uterine rupture, and placental-related disorders such as preeclampsia, spontaneous preterm delivery, and placental abruption.

Maternal age and adverse perinatal outcomes in a birth cohort (BRISA) from a Northeastern Brazilian city

PURPOSE:To verify the existence of associations between different maternal ages and the perinatal outcomes of preterm birth and intrauterine growth restriction in the city of São Luís, Maranhão, Northeastern Brazil.METHODS:A cross-sectional study using a sample of 5,063 hospital births was conducted in São Luís, from January to December 2010. The participants comprise the birth cohort for the study "Etiological factors of preterm birth and consequences of perinatal factors for infant health: birth cohorts from two Brazilian cities" (BRISA). Frequencies and 95% confidence intervals were used to describe the results. Multiple logistic regression models were applied to assess the adjusted odds ratio (OR) of maternal age associated with the following outcomes: preterm birth and intrauterine growth restriction.RESULTS:The percentage of early teenage pregnancy (12–15 years old) was 2.2%, and of late (16–19 years old) was 16.4%, while pregnancy at an advanced maternal age (>35 years) was 5.9%. Multivariate analyses showed a statistically significant increase in preterm births among females aged 12–15 years old (OR=1.6; p=0.04) compared with those aged 20–35 years. There was also a higher rate in preterm births among females aged 16–19 years old (OR=1.3; p=0.01). Among those with advanced maternal age (>35 years old), the increase in the prevalence of preterm birth had only borderline statistical significance (OR=1.4; p=0.05). There was no statistically significant association between maternal age and increased prevalence of intrauterine growth restriction.

Increasing the percentage of vaginal birth in the private sector in Brazil through the redesign of care model

OBJETIVO: Implantar um novo modelo de cuidado ao parto e reduzir o percentual de cesarianas entre as gestantes da UNIMED Jaboticabal.MÉTODOS: Estudo descritivo desenvolvido em uma instituição do interior paulista, que teve início em 2012 e propôs o redesenho do modelo de cuidado ao parto com a revisão de todo o processo assistencial por meio da Ciência da Melhoria Contínua. Para medir os resultados das mudanças, foram selecionados nove indicadores e suas respectivas metas.RESULTADOS: O indicador de partos vaginais atingiu a meta de 40%, após sete meses do início da intervenção. Este indicador entre as gestantes do SUS atingiu 66%. A taxa de mortalidade perinatal decresceu 25% comparando-se 2012 a 2014 e a taxa de prematuridade foi de 3/100 nascidos vivos em 2014. O percentual de gestantes da UNIMED com 6 ou mais consultas de pré-natal atingiu 95%. Em relação aos custos hospitalares per capita referentes à assistência ao parto, notou-se um decréscimo de 27%, quando comparados os anos de 2012 e 2013. Tal queda não se sustentou e o custo hospitalar per capita, em 2014, retornou aos mesmos patamares de 2012. A remuneração dos obstetras registrou um acréscimo de 72%, se comparados os anos de 2012, 2013 e 2014. Houve queda de 61% dos custos com a unidade de terapia intensiva (UTI) neonatal, comparando os anos de 2012 e 2013. A taxa de admissão em UTI neonatal acompanhou a redução dos custos e foi de 55%, se comparados os anos de 2012 a 2014, entre as gestantes da UNIMED. Não houve o alcance da meta de 80% de participação das gestantes nos cursos de preparação para o nascimento. A porcentagem de gestantes satisfeitas e muito satisfeitas com a assistência ao parto atingiu 86%.CONCLUSÃO: Este projeto atingiu seus objetivos, reduzindo o percentual de cesarianas entre as gestantes da UNIMED Jaboticabal, e constituiu-se em um exemplo concreto da realização do triplo objetivo em saúde: melhorar a experiência dos envolvidos e os resultados de saúde de populações e indivíduos e realizar estas duas tarefas com menor custo, eliminando desperdícios assistenciais.

Effectiveness of an illustrated home exercise guide on promoting urinary continence during pregnancy: a pragmatic randomized clinical trial

OBJETIVO: Avaliar a efetividade de um manual de orientação de exercícios domiciliares (MOED) para o assoalho pélvico (AP) na promoção da continência urinária em gestantes primigestas.MÉTODOS: Ensaio clínico com 87 participantes, avaliadas 6 vezes durante a gestação e divididas aleatoriamente em 3 grupos: Grupo supervisionado (Gsup), que praticou exercícios com supervisão; Grupo observado (Gobs), que praticou exercícios sem supervisão, e Grupo referência (Gref), que não praticou exercícios. Incontinência urinária (IU) (desfecho primário) e força muscular perineal (FMP) (desfecho secundário) foram avaliadas por intermédio de diário de perdas urinárias e perineometria, respectivamente. Foram utilizados o teste de Kruskal-Wallis, seguido do teste post hoc de Dunn, para variáveis contínuas, e o teste do χ2 e testes Z, com correções de Bonferroni, para proporções, com nível de significância de 5%.RESULTADOS: O Gsup e o Gobs apresentaram 6,9% de gestantes incontinentes, enquanto o Gref apresentou 96,6% de incontinentes. Quanto à FMP, o Gsup e o Gobs apresentaram valores médios de contração de 10 e 8,9 cmH2O, respectivamente, enquanto o Gref apresentou valor de 4,7 cmH2O. Ambos os resultados significantes.CONCLUSÃO: A utilização de um MOED é eficaz na promoção da continência urinária e no aumento da FMP em gestantes primigestas, independentemente de supervisão permanente.

A surveillance of enteropathogens in piglets from birth to seven days of age in Brazil

The purpose of the study was to evaluate the real importance of anaerobic enteropathogens and rotavirus in contrast to more common agents as cause of diarrhea in piglets within the first week of life. Sixty 1- to 7-day-old piglets, 30 diarrheic and 30 non-diarrheic (control), from 15 different herds were selected, euthanized and necropsied. Samples of the jejunum, ileum, colon, cecum and feces were collected from the piglets and analyzed to determine the presence of the following enteropathogens: enterotoxigenic Escherichia coli (ETEC), Clostridium perfringens types A and C, Clostridium difficile, rotavirus and Isospora suis. Among diarrheic piglets, 23.3% were positive for C. difficile, 70% for C. perfringens type A cpb2+, 14.3% for rotavirus and 10% for ETEC. Among non-diarrheic control piglets, 10% were positive for C. difficile, 76.7% for C. perfringens type A cpb2+, 0% for rotavirus, 3.3% for ETEC and 3.3% for I. suis. C. perfringens type C was not detected in any of the animals. Histological lesions characteristic of C. difficile, E. coli and rotavirus were observed. However, no C. perfringens type A suggestive lesions were detected. There was a positive correlation between mesocolon edema and the presence of C. difficile toxins. Although C. perfringens type A cpb2+ was the most frequently detected enteropathogen, there was no association between its presence and diarrhea or macro or microscopic changes. C. difficile and Rotavirus were the most relevant pathogens involved with neonatal diarrhea in this study, and histopathology associated with microbiological test proved to be the key to reach a final diagnosis.

Porin Kuudennen osan tarinoista rakennettu kulttuuriperintö

Tutkimus käsittelee viranomaisten ja asukkaiden välistä vuorovaikutusta kaavaprosessin aikana. Tutkimusalueena on valtakunnallisesti merkittäväksi kulttuuriympäristöksi luokiteltu Porin Kuudes osa, joka on yksi laajimmista yhtenäisenä säilyneistä 1800-luvun lopun puukaupunkialueista Suomessa. Hermeneuttis-fenomenologista otetta soveltava tutkimus perustuu muistitietoaineistoon, joka avaa näkökulman paikallisen kulttuuriperinnön syntymiseen, periytymiseen ja muutokseen. Kuudennen osan vuonna 2012 voimaan tulleessa asemakaavamuutoksessa suojeltiin 405 rakennusta. Sekä viranomaiset että asukkaat haluavat säilyttää arvokkaan ympäristön jälkipolville. Asukkaiden ja viranomaisten lähtökohdat arvottamiselle ovat kuitenkin erilaiset. Asiantuntijoiden näkemys kulttuuriympäristön arvoista perustuu eksplisiittiseen viralliseen tietoon, joka heijastaa positivistista käsitystä maailmasta mitattavista objekteista koostuvana kokonaisuutena. Asukkaiden arvostus asuinaluetta ja sen rakennuksia kohtaan puolestaan nousee sukupolvelta toiselle siirretyn aineettoman perinnön yhteisöllisestä merkityksestä. Heidän kokemuksensa kiteytyy kodin ja kotiseudun käsitteissä ja se tuodaan esiin rakennuksiin liittyvissä tarinoissa. Tulkinta on virallista tietoa haastavaa ja täydentävää. Kestäviä suojelupäätöksiä voidaan tehdä vain viranomaisten ja asukkaiden väliseen tasa-arvoiseen vuoropuheluun perustuen. Tutkimus nostaa asukkaiden kokemuksellisen, paikkaan sitoutuneen hiljaisen tiedon virallisen tiedon rinnalle, kulttuurisesti kestävän maankäytön suunnittelun perustaksi. Koska ihminen toimii sellaisten asioiden puolesta, jotka hän kokee arvokkaaksi, asukaslähtöinen rakennussuojelu on lähtökohtaisesti yhteisön omakseen kokeman aineettoman kulttuuriperinnön suojelua.

ZENODO - an open dependable home for the long-tail of science

Poster at Open Repositories 2014, Helsinki, Finland, June 9-13, 2014