644 resultados para Piha, Kirsi
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Mexican and Peruvian hairless dogs and Chinese crested dogs are characterized by missing hair and teeth, a phenotype termed canine ectodermal dysplasia (CED). CED is inherited as a monogenic autosomal semidominant trait. With genomewide association analysis we mapped the CED mutation to a 102-kilo-base pair interval on chromosome 17. The associated interval contains a previously uncharacterized member of the forkhead box transcription factor family (FOXI3), which is specifically expressed in developing hair and teeth. Mutation analysis revealed a frameshift mutation within the FOXI3 coding sequence in hairless dogs. Thus, we have identified FOXI3 as a regulator of ectodermal development.
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INTRODUCTION Dexmedetomidine was shown in two European randomized double-blind double-dummy trials (PRODEX and MIDEX) to be non-inferior to propofol and midazolam in maintaining target sedation levels in mechanically ventilated intensive care unit (ICU) patients. Additionally, dexmedetomidine shortened the time to extubation versus both standard sedatives, suggesting that it may reduce ICU resource needs and thus lower ICU costs. Considering resource utilization data from these two trials, we performed a secondary, cost-minimization analysis assessing the economics of dexmedetomidine versus standard care sedation. METHODS The total ICU costs associated with each study sedative were calculated on the basis of total study sedative consumption and the number of days patients remained intubated, required non-invasive ventilation, or required ICU care without mechanical ventilation. The daily unit costs for these three consecutive ICU periods were set to decline toward discharge, reflecting the observed reduction in mean daily Therapeutic Intervention Scoring System (TISS) points between the periods. A number of additional sensitivity analyses were performed, including one in which the total ICU costs were based on the cumulative sum of daily TISS points over the ICU period, and two further scenarios, with declining direct variable daily costs only. RESULTS Based on pooled data from both trials, sedation with dexmedetomidine resulted in lower total ICU costs than using the standard sedatives, with a difference of €2,656 in the median (interquartile range) total ICU costs-€11,864 (€7,070 to €23,457) versus €14,520 (€7,871 to €26,254)-and €1,649 in the mean total ICU costs. The median (mean) total ICU costs with dexmedetomidine compared with those of propofol or midazolam were €1,292 (€747) and €3,573 (€2,536) lower, respectively. The result was robust, indicating lower costs with dexmedetomidine in all sensitivity analyses, including those in which only direct variable ICU costs were considered. The likelihood of dexmedetomidine resulting in lower total ICU costs compared with pooled standard care was 91.0% (72.4% versus propofol and 98.0% versus midazolam). CONCLUSIONS From an economic point of view, dexmedetomidine appears to be a preferable option compared with standard sedatives for providing light to moderate ICU sedation exceeding 24 hours. The savings potential results primarily from shorter time to extubation. TRIAL REGISTRATION ClinicalTrials.gov NCT00479661 (PRODEX), NCT00481312 (MIDEX).
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Purpose The purpose of this paper is to present what kind of elements and evaluation methods should be included into a framework for evaluating the achievements and impacts of transport projects supported in EC Framework Programmes (FP). Further, the paper discusses the possibilities of such an evaluation framework in producing recommendations regarding future transport research and policy objectives as well as mutual learning for the basis of strategic long term planning. Methods The paper describes the two-dimensional evaluation methodology developed in the course of the FP7 METRONOME project. The dimensions are: (1) achievement of project objectives and targets in different levels and (2) research project impacts according to four impact groups. The methodology uses four complementary approaches in evaluation, namely evaluation matrices, coordinator questionnaires, lead user interviews and workshops. Results Based on the methodology testing, with a sample of FP5 and FP6 projects, the main results relating to the rationale, implementation and achievements of FP projects is presented. In general, achievement of objectives in both FPs was good. Strongest impacts were identified within the impact group of management and co-ordination. Also scientific and end-user impacts of the projects were adequate, but wider societal impacts quite modest. The paper concludes with a discussion both on the theoretical and practical implications of the proposed methodology and by presenting some relevant future research needs.
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The potential shown by Lean in different domains has aroused interest in the software industry. However, it remains unclear how Lean can be effectively applied in a domain such as software development that is fundamentally different from manufacturing. This study explores how Lean principles are implemented in software development companies and the challenges that arise when applying Lean Software Development. For that, a case study was conducted at Ericsson R&D Finland, which successfully adopted Scrum in 2009 and subsequently started a comprehensible transition to Lean in 2010. Focus groups were conducted with company representatives to help devise a questionnaire supporting the creation of a Lean mindset in the company (Team Amplifier). Afterwards, the questionnaire was used in 16 teams based in Finland, Hungary and China to evaluate the status of the transformation. By using Lean thinking, Ericsson R&D Finland has made important improvements to the quality of its products, customer satisfaction and transparency within the organization. Moreover, build times have been reduced over ten times and the number of commits per day has increased roughly five times.The study makes two main contributions to research. First, the main factors that have enabled Ericsson R&D?s achievements are analysed. Elements such as ?network of product owners?, ?continuous integration?, ?work in progress limits? and ?communities of practice? have been identified as being of fundamental importance. Second, three categories of challenges in using Lean Software Development were identified: ?achieving flow?, ?transparency? and ?creating a learning culture?
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Background - The onset of bipolar disorder is influenced by the interaction of genetic and environmental factors. We previously found that a large increase in sunlight in springtime was associated with a lower age of onset. This study extends this analysis with more collection sites at diverse locations, and includes family history and polarity of first episode. Methods - Data from 4037 patients with bipolar I disorder were collected at 36 collection sites in 23 countries at latitudes spanning 3.2 north (N) to 63.4 N and 38.2 south (S) of the equator. The age of onset of the first episode, onset location, family history of mood disorders, and polarity of first episode were obtained retrospectively, from patient records and/or direct interview. Solar insolation data were obtained for the onset locations. Results - There was a large, significant inverse relationship between maximum monthly increase in solar insolation and age of onset, controlling for the country median age and the birth cohort. The effect was reduced by half if there was no family history. The maximum monthly increase in solar insolation occurred in springtime. The effect was one-third smaller for initial episodes of mania than depression. The largest maximum monthly increase in solar insolation occurred in northern latitudes such as Oslo, Norway, and warm and dry areas such as Los Angeles, California. Limitations - Recall bias for onset and family history data. Conclusions - A large springtime increase in sunlight may have an important influence on the onset of bipolar disorder, especially in those with a family history of mood disorders.
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Background: Environmental conditions early in life may imprint the circadian system and influence response to environmental signals later in life. We previously determined that a large springtime increase in solar insolation at the onset location was associated with a younger age of onset of bipolar disorder, especially with a family history of mood disorders. This study investigated whether the hours of daylight at the birth location affected this association. Methods: Data collected previously at 36 collection sites from 23 countries were available for 3896 patients with bipolar I disorder, born between latitudes of 1.4N and 70.7N, and 1.2S and 41.3S. Hours of daylight variables for the birth location were added to a base model to assess the relation between the age of onset and solar insolation. Results: More hours of daylight at the birth location during early life was associated with an older age of onset, suggesting reduced vulnerability to the future circadian challenge of the springtime increase in solar insolation at the onset location. Addition of the minimum of the average monthly hours of daylight during the first 3 months of life improved the base model, with a significant positive relationship to age of onset. Coefficients for all other variables remained stable, significant and consistent with the base model. Conclusions: Light exposure during early life may have important consequences for those who are susceptible to bipolar disorder, especially at latitudes with little natural light in winter. This study indirectly supports the concept that early life exposure to light may affect the long term adaptability to respond to a circadian challenge later in life.
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There is considerable international interest in online education of patients with bipolar disorder, yet little understanding of how patients use the Internet and other sources to seek information. 1171 patients with bipolar disorder diagnosis in 17 countries completed a paper-based, anonymous survey. 81% of the patients used the Internet, a percentage similar to the general public. Older age, less education, and challenges in country telecommunications infrastructure and demographics decreased the odds of using the Internet. About 78% of the Internet users looked online for information on bipolar disorder or 63% of the total sample. More years of education in relation to the country mean, and feeling very confident about managing life decreased the odds of seeking information on bipolar disorder online, while having attended support groups increased the odds. Patients who looked online for information on bipolar disorder consulted medical professionals plus a mean of 2.3 other information sources such as books, physician handouts, and others with bipolar disorder. Patients not using the Internet consulted medical professionals plus a mean of 1.6 other information sources. The percentage of patients with bipolar disorder who use the Internet is about the same as the general public. Other information sources remain important.
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Background: Information seeking is an important coping mechanism for dealing with chronic illness. Despite a growing number of mental health websites, there is little understanding of how patients with bipolar disorder use the Internet to seek information. Methods: A 39 question, paper-based, anonymous survey, translated into 12 languages, was completed by 1222 patients in 17 countries as a convenience sample between March 2014 and January 2016. All patients had a diagnosis of bipolar disorder from a psychiatrist. Data were analyzed using descriptive statistics and generalized estimating equations to account for correlated data. Results: 976 (81 % of 1212 valid responses) of the patients used the Internet, and of these 750 (77 %) looked for information on bipolar disorder. When looking online for information, 89 % used a computer rather than a smartphone, and 79 % started with a general search engine. The primary reasons for searching were drug side effects (51 %), to learn anonymously (43 %), and for help coping (39 %). About 1/3 rated their search skills as expert, and 2/3 as basic or intermediate. 59 % preferred a website on mental illness and 33 % preferred Wikipedia. Only 20 % read or participated in online support groups. Most patients (62 %) searched a couple times a year. Online information seeking helped about 2/3 to cope (41 % of the entire sample). About 2/3 did not discuss Internet findings with their doctor. Conclusion: Online information seeking helps many patients to cope although alternative information sources remain important. Most patients do not discuss Internet findings with their doctor, and concern remains about the quality of online information especially related to prescription drugs. Patients may not rate search skills accurately, and may not understand limitations of online privacy. More patient education about online information searching is needed and physicians should recommend a few high quality websites.
THE COSTS OF RAISING EQUITY RATIO FOR BANKS Evidence from publicly listed banks operating in Finland
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The solvency rate of banks differs from the other corporations. The equity rate of a bank is lower than it is in corporations of other field of business. However, functional banking industry has huge impact on the whole society. The equity rate of a bank needs to be higher because that makes the banking industry more stable as the probability of the banks going under will decrease. If a bank goes belly up, the government will be compensating the deposits since it has granted the bank’s depositors a deposit insurance. This means that the payment comes from the tax payers in the last resort. Economic conversation has long concentrated on the costs of raising equity ratio. It has been a common belief that raising equity ratio also increases the banks’ funding costs in the same phase and these costs will be redistributed to the banks customers as higher service charges. Regardless of the common belief, the actual reaction of the funding costs to the higher equity ratio has been studied only a little in Europe and no study has been constructed in Finland. Before it can be calculated whether the higher stability of the banking industry that is caused by the raise in equity levels compensates the extra costs in funding costs, it must be calculated how much the actual increase in the funding costs is. Currently the banking industry is controlled by complex and heavy regulation. To maintain such a complex system inflicts major costs in itself. This research leans on the Modigliani and Miller theory, which shows that the finance structure of a firm is irrelevant to their funding costs. In addition, this research follows the calculations of Miller, Yang ja Marcheggianon (2012) and Vale (2011) where they calculate the funding costs after the doubling of specific banks’ equity ratios. The Finnish banks studied in this research are Nordea and Danske Bank because they are the two largest banks operating in Finland and they both also have the right company form to able the calculations. To calculate the costs of halving their leverages this study used the Capital Asset Pricing Model. The halving of the leverage of Danske Bank raised its funding costs for 16—257 basis points depending on the method of assessment. For Nordea the increase in funding costs was 11—186 basis points when its leverage was halved. On the behalf of the results found in this study it can be said that the doubling of an equity ratio does not increase the funding costs of a bank one by one. Actually the increase is quite modest. More solvent banks would increase the stability of the banking industry enormously while the increase in funding costs is low. If the costs of bank regulation exceeds the increase in funding costs after the higher equity ratio, it can be thought that this is the better way of stabilizing the banking industry rather than heavy regulation.
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Tässä tutkimuksessa selvitettiin minkälaista tietoa haastattelu ja sadutus antavat lasten kokemuksesta lastenkirjallisuudesta ja miten nämä tiedonhankintatavat näyttäytyvät suhteessa lapsen osallisuuteen. Kielellisten taitojen perusteella tutkimuskohteeksi valittiin esikouluikäiset lapset. Tutkimuksen otos oli yhden kokopäiväryhmän esikoululaiset, joista neljä viidestä halusi olla mukana tutkimuksessa. Lapsille luettiin pienryhmässä kirja Pikkuveli ja Katto-Kassinen. Tämän jälkeen heidät haastateltiin ja sadutettiin. Aineisto järjestettiin sisällönanalysointimenetelmin. Haastattelu toi näkyväksi lapsen muistia ja ymmärrystä kirjan henkilöistä ja tapahtumista. Sadutuksessa näkyi enemmänkin lapsen intuitio kirjasta ja sen päähenkilön hahmosta. Sadutuksen kautta lapset ilmaisivat positiivisia mielikuviaan kirjasta, kun taas haastattelu toi esiin laajemman skaalan kirjan sisäisistä skeemoista. Sadutus menetelmänä on osallistavampi kuin haastattelu, mutta molemmissa menetelmissä osallisuuden aste riippuu lapsen tietoisuudesta taustalla vaikuttavasta ajatusmaailmasta. Miksi tätä tehdään ja kuka on päättänyt minun osallistumisestani toimintaan? Tutkimusta tehdessä selkeni myös, että molemmat tavat voivat olla monella eri osallisuuden tasolla, riippuen juuri vastauksista aiempiin kysymyksiin. Myös lapsen ollessa tilanteessa toimijana, voi osallisuuden taso muuttua riippuen lapsen tai tilanteen kehittymisestä.
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Tutkielmassa tarkastellaan johdon harkinnanvaraisuutta tuloksenjärjestelyn mahdollistajana IFRS-kontekstissa tilintarkastajan näkökulmasta. Tuloksenjärjestely ilmenee silloin, kun johto käyttää harkinnanvaraisuutta taloudellisessa raportoinnissa ja muuttaa raportointia sellaiseksi, joka ei vastaa yrityksen sen hetkistä taloudellista suoriutumista. Tutkimuksen tavoitteena on saada selville, miten harkinnanvaraisuuden oikeellisuudesta voidaan varmentua IFRS-raportointia noudattavissa, suomalaisissa yhtiöissä. Tutkimuksen tarkoituksena on tarjota uutta tietoa IFRS:n sisältämästä harkinnanvaraisuudesta nojautumalla tilintarkastajan näkökulmaan. Tämän tavoitteena on lisätä informaatiota puutteellisesta näkökulmasta, millä avataan myös aikaisempien tutkimustuloksien ristiriitaa liittyen tuloksenjärjestelyn harjoittamisen mahdollisuuksiin IFRS-kontekstissa. Lisäksi tutkimuksen tarkoituksena on saada selville, miten johdon harkinnanvaran asianmukaisuutta voidaan kyseenalaistaa. Tuloksenjärjestelyä käsittävä tutkimus on lähes poikkeuksetta kvantitatiivista keskittyen tilinpäätöksistä johdettuihin, yleistettäviin tilastollisiin analyyseihin. Tuloksenjärjestelyn on kuitenkin todettu olevan aiempaa tiedettyä monimuotoisempi ilmiö, joka edellyttää kvantitatiivisten menetelmien sijaan kvalitatiivista lähestymistapaa. Tämä tutkielma keskittyykin tutkimaan tuloksenjärjestelyä laadullisin menetelmin käyttämällä toiminta-analyyttista tutkimusotetta. Tutkimuksen empiirinen aineisto muodostuu puolestaan neljästä puolistrukturoidusta yksilöhaastattelusta. Kaikki haastateltavat työskentelevät KHT-tilintarkastajina yhdessä Suomen suurimmassa tilintarkastusorganisaatiossa. Tämä tutkimus vahvistaa aikaisempia tutkimustuloksia, joiden mukaan IFRS-standardit edellyttävät runsaasti johdon harkintaa. Lisäksi tässä tutkielmassa todetaan, että arvionvaraisten erien tarkastamiseen on useita eri tapoja. Mikään näistä ei kuitenkaan tarjoa tilintarkastajille absoluuttista vastausta siitä, onko harkintaa käytetty asianmukaisella tavalla. Tämän vuoksi tilintarkastajat joutuvatkin usein tasapainottelemaan johdon harkinnanvaran asianmukaisuuden suhteen. Lisäksi tutkimuksessa havaitaan, että tilintarkastajien kynnys lähteä kyseenalaistamaan johdon harkinnanvaran asianmukaisuutta on korkea. Ensimmäiseksi tämä tutkimus lisää ymmärrystä tilintarkastajien merkityksestä harkinnanvaraisten erien tarkastamisessa. Tutkielman mukaan harkinnanvaraiset erät eivät nimittäin ole aiemman tietämyksen tapaan pelkästään alttiita johdon subjektiivisille näkemyksille, vaan niiden tarkastaminen edellyttää myös tilintarkastajilta subjektiivista tulkintaa. Toiseksi tämä tutkimus tuo uutuusarvoa aikaisempiin tutkimuksiin nostamalla esiin tilintarkastajien kokeman riskin asiakasmenetyksistä osana harkinnanvaraisten erien tarkastamista ja kyseenalaistamista.
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The Marine Strategy Framework Directive (2008/56/EC) (MSFD) requires that the European Commission (by 15 July 2010) should lay down criteria and methodological standards to allow consistency in approach in evaluating the extent to which Good Environmental Status (GES) is being achieved. ICES and JRC were contracted to provide scientific support for the Commission in meeting this obligation. A total of 10 reports have been prepared relating to the descriptors of GES listed in Annex I of the Directive. Eight reports have been prepared by groups of independent experts coordinated by JRC and ICES in response to this contract. In addition, reports for two descriptors (Contaminants in fish and other seafood and Marine Litter) were written by expert groups coordinated by DG SANCO and IFREMER respectively. A Task Group was established for each of the qualitative Descriptors. Each Task Group consisted of selected experts providing experience related to the four marine regions (the Baltic Sea, the North-east Atlantic, the Mediterranean Sea and the Black Sea) and an appropriate scope of relevant scientific expertise. Observers from the Regional Seas Conventions were also invited to each Task Group to help ensure the inclusion of relevant work by those Conventions. This is the report of Task Group 8 Contaminants and pollution effects.
THE COSTS OF RAISING EQUITY RATIO FOR BANKS Evidence from publicly listed banks operating in Finland
Resumo:
The solvency rate of banks differs from the other corporations. The equity rate of a bank is lower than it is in corporations of other field of business. However, functional banking industry has huge impact on the whole society. The equity rate of a bank needs to be higher because that makes the banking industry more stable as the probability of the banks going under will decrease. If a bank goes belly up, the government will be compensating the deposits since it has granted the bank’s depositors a deposit insurance. This means that the payment comes from the tax payers in the last resort. Economic conversation has long concentrated on the costs of raising equity ratio. It has been a common belief that raising equity ratio also increases the banks’ funding costs in the same phase and these costs will be redistributed to the banks customers as higher service charges. Regardless of the common belief, the actual reaction of the funding costs to the higher equity ratio has been studied only a little in Europe and no study has been constructed in Finland. Before it can be calculated whether the higher stability of the banking industry that is caused by the raise in equity levels compensates the extra costs in funding costs, it must be calculated how much the actual increase in the funding costs is. Currently the banking industry is controlled by complex and heavy regulation. To maintain such a complex system inflicts major costs in itself. This research leans on the Modigliani and Miller theory, which shows that the finance structure of a firm is irrelevant to their funding costs. In addition, this research follows the calculations of Miller, Yang ja Marcheggianon (2012) and Vale (2011) where they calculate the funding costs after the doubling of specific banks’ equity ratios. The Finnish banks studied in this research are Nordea and Danske Bank because they are the two largest banks operating in Finland and they both also have the right company form to able the calculations. To calculate the costs of halving their leverages this study used the Capital Asset Pricing Model. The halving of the leverage of Danske Bank raised its funding costs for 16—257 basis points depending on the method of assessment. For Nordea the increase in funding costs was 11—186 basis points when its leverage was halved. On the behalf of the results found in this study it can be said that the doubling of an equity ratio does not increase the funding costs of a bank one by one. Actually the increase is quite modest. More solvent banks would increase the stability of the banking industry enormously while the increase in funding costs is low. If the costs of bank regulation exceeds the increase in funding costs after the higher equity ratio, it can be thought that this is the better way of stabilizing the banking industry rather than heavy regulation.
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Kliininen lääketutkimus on ihmiseen kohdistuva interventiotutkimus, jonka tavoitteena on selvittää lääkeaineiden farmakodynaamisia sekä farmakokineettisiä ominaisuuksia ihmiselimistössä. Tutkittavien rekrytointi kliinisiin lääketutkimuksiin voi olla haastavaa ja hidasta, mikä vaikeuttaa tutkimuksen suorittamista. Biopankki on yksikkö, johon on säilöttynä ihmisperäisiä näytteitä ja niihin liitettyjä terveystietoja, joita voidaan käyttää biopankkitutkimusten tekemiseen. Vuonna 2013 astui voimaan Biopankkilaki (688/2012), jonka myötä Suomeen on perustettu yhdeksän biopankkia. Tämän projektin tarkoituksena oli selvittää, miten Auria Biopankin näyte- ja tietorekisteriä voitaisiin hyödyntää tutkittavien rekrytoimiseksi kliinisiin lääketutkimuksiin. Projekti on toteutettu yhteistyössä Auria Biopankin kanssa. Projektia varten valittiin kuusi lääkekehityksen kannalta mielenkiintoista ja ajankohtaista sairautta, jotka ovat: Alzheimerin tauti, idiopaattinen keuhkofibroosi (IPF), multippeliskleroosi eli MS-tauti, eturauhassyöpä, ei-pienisoluinen keuhkosyöpä sekä monisysteemiatrofia (MSA). Jokaiselle sairaudelle suoritettiin näyte- ja tietorekisterihaku Auria Biopankin rekisteristä. Hakua varten luotiin sairauskohtaiset tutkittavien mukaanotto- ja poissulkukriteerit, suoritettujen todellisten kliinisten lääketutkimusten kriteereitä apuna käyttäen. Näyte- ja tietorekisterihaun tarkoituksena oli selvittää, kuinka monta kriteereitä vastaavaa henkilöä biopankin rekisterissä on, ja voidaanko heiltä biopankin välityksellä tiedustella halukkuutta ottaa osaa kliiniseen lääketutkimukseen. Projektin toisena osana luotiin toimintamalleja sekä mallikirjeitä biopankin välityksellä tapahtuvaa yhteydenottoa varten. Varsinaista yhteydenottoa sopiviin henkilöihin ei tämän projektin yhteydessä suoritettu. Suurinosa Auria Biopankin näytteistä on kerätty sairaalahoidon yhteydessä, joten oletettavasti erikoissairaanhoidossa hoidettavat sairaudet ovat kattavammin edustettuina biopankin rekisterissä. Tietorekisterihaun tuloksista tämä ei kuitenkaan ole suoraan havaittavissa. Valituista sairauksista eturauhassyöpää sairastavia kriteerit täyttäviä potilaita löytyi hieman alle 130, kun Alzheimerin taudin, IPF:n, ja MSA:n kohdalla luku jäi alle kymmeneen. MS-tautia sairastavia henkilöitä löytyi alle 20 ja ei-pienisoluista keuhkosyöpää sairastavia noin 10. Biopankkilain mukainen biopankkitoiminta on Suomessa vielä uutta. Aktiivisten biopankkisuostumusten määrä tulee todennäköisesti kasvamaan voimakkaasti seuraavien vuosien aikana, mikä mahdollistaa biopankkien näyte- ja tietorekisterien kasvun ja tiedon nykyistä paremman hyödyntämisen. Mitä enemmän on biopankkisuostumuksen antaneita henkilöitä, sitä enemmän on henkilöitä tavoitettavissa biopankin välityksellä myös kliinisiin lääketutkimuksiin liittyen.