Budjetointi ja rahoitusbudjetointi case yrityksessä.

Tämän tutkielman päätavoitteena oli tutkia case yrityksen tulosbudjetointia ja rahoitusbudjetointia sekä niihin vaikuttavia tekijöitä. Tarkoituksena oli kartoittaa ja analysoida case yrityksen rahoitusbudjetoinnin ongelmakohtia ja esittää yritykselle kehitysehdotuksia.

Language Flexibility: The Effects of Finnish-Swedish Bilingualism on EFL Acquisition

Tutkielmassa käsitellään vieraan kielen, ts. englannin, oppimista peruskoulussa. Hypoteesina oletetaan, että oppilaat, jotka jo hallitsevat kaksi kieltä, menestyvät paremmin vieraan kielen oppimisessa kuin yksikieliset oppilaat. Tutkielmassa vertaillaan kaksikielisten ja yksikielisten oppilaiden englannin kielen taitoja alakoulun kuudennen luokan päättyessä. Kaksikielisyys voidaan ymmärtää monella tavalla, ja tutkimustulokset kaksikielisyyden vaikutuksista ovat usein olleet ristiriitaisia. Siksi tutkielmassa ensin määritellään kaksikielisyys, sen lajit sekä siihen liittyvää terminologiaa. Lisäksi kuvaillaan Suomen sekä erityisesti Turun kaupungin kaksikielisen väestön tilaa ja oikeuksia sekä keskustellaan aikaisempien tutkimusten perusteella mahdollisista ongelmista ja hyödyistä, joita kaksikielisyyteen liittyy. Kaksikielisyyteen on perinteisesti liittynyt myös paljon ennakkoluuloja, kuten pelko puolikielisyydestä, jotka tieteellisten tutkimusten avulla pyritään kumoamaan. Mahdollisia muita ongelmia, kuten pienempi sanavarasto molemmissa kielissä verrattuna saman ikäisiin yksikielisiin sekä reaktioaikojen piteneminen, kuitenkin esiintyy. Kaksikielisyyden hyötyjä sen sijaan voivat olla mm. luovuus, kyky kielen analyyttiseen tarkasteluun, metalingvististen taitojen kehittyminen ja avoimuus muita kieliä ja kulttuureita kohtaan. Kaikki mainitut edut ja haitat myös vaikuttavat vieraan kielen opinnoissa menestymiseen. Myös mahdollinen positiivinen transferenssi otetaan huomioon. Tutkimuksen empiiristä osaa varten vierailtiin kahdessa turkulaisessa alakoulussa, joiden kuudennen luokan oppilaat suorittivat kaksi englannin kielen tehtävää. Toinen kouluista oli suomenkielinen, jonka oppilaat edustivat yksikielistä vertailuryhmää (n=31). Ruotsinkielinen koulu valittiin edustamaan kaksikielistä ryhmää (n=34), sillä yleensä Suomessa ja kaupungeissa kuten Turussa vähemmistökielen puhujat hallitsevat käytännössä usein myös suomen kielen. Ruotsinkielisen koulun oppilaiden kaksikielisyys varmistettiin kielitaustakyselyllä. Kaksikielisten oppilaiden tulokset molemmissa tehtävissä olivat hieman paremmat kuin yksikielisten. Yksikielisessä ryhmässä myös tulosten keskihajonta oli suurempi. Kaksikieliset näyttivät hallitsevan kielen analyyttisen tarkastelun paremmin sekä tekivät vähemmän kieliopillisia virheitä. Positiivisen transferenssin vaikutus oli myös nähtävissä. Toisaalta heillä oli enemmän oikeinkirjoitusvirheitä vastauksissaan.Merkittäviä eroja ei kuitenkaan englannin kielen oppimisessa voitu todentaa.

Orofacial pain of cardiac origin: review literature and clinical cases

The most common types of orofacial pain originate at the dental or periodontal level or in the musculoskeletal structures. However, the patient may present pain in this region even though the source is located elsewhere in the body. One possible source of heterotopic pain is of cardiac origin. Objectives: Report two cases of orofacial pain of cardiac origin and review the clinical cases described in the literature. Study Design: Description of clinical cases and review of clinical cases. Results and conclusions: Nine cases of atypical pain of cardiac origin are recorded, which include 5 females and 4 males. In craniofacial structures, pain of cardiac origin is usually bilateral. At the craniofacial level, the most frequent location described is in the throat and jaw. Pain of cardiac origin is considered atypical due to its location, although roughly 10% of the cases of cardiac ischemia manifest primarily in craniofacial structures. Finally, the differential diagnosis of pain of odontogenic origin must be taken into account with pain of non-odontogenic origin (muscle, psychogenic, neuronal, cardiac, sinus and neurovascular pain) in order to avoid diagnostic errors in the dental practice as well as unnecessary treatments.

Myofascial pain associated to trigger points: A literature review. Part 2: Differential diagnosis and treatment

During the last decades the advance in knowledge of myofascial pain has been constant in the medical and dental community. However, although several aspects have been clarified in relation to its epidemiology, clinical characteristics and etiopathogenesis, many uncertainties remain. Many clinical conditions are included in the differential diagnosis of myofascial pain associated to trigger points. A good anamnesis and clinical exploration is thus required in order to ensure correct diagnosis and treatment. Among the numerous treatments used in application to trigger points, the spray-and-stretch technique and direct injection targeted to such trigger points have been found to be the most effective options. In chronic cases, psychosocial intervention is required, due to the high incidence of mood disorders and/or anxiety observed in these patients, who in turn present a poorer prognosis. This underscores the importance of early diagnosis and treatment.

Market Orientation in Rapidly Internationalizing Small Companies — Evidence from the Software Industry

For more than a decade, researchers have been aware of the increased pace of small-firm internationalization and the greater effect of these rapidly growing small businesses on the wealth, international trade, and job-creation opportunities of countries. Due to the small size of the home market, Finnish companies have been generally considered highly interested in internationalization. One particular domain in which rapid internationalization has been considered feasible is the global software business, with its knowledge-intensive nature and high growth potential. However, over time the failure rate of small entrepreneurial firms has remained especially high in high-technology markets. One of the reasons for this seems to lie in the fact that these companies are often formed by people with a strong technological background but limited competences in other areas. Further, research on the marketing capabilities of rapidly internationalizing high-tech firms has been scarce thus far. In addition, while there is much research on the first years of operations of rapidly internationalizing companies, it is not well known what becomes of them later on. Therefore, there is a need for more investigation into the managerial mindset, competences and decision-making in these small companies, especially from the perspective of how they acquire and exploit market knowledge, and enhance their networking capabilities in order to promote international expansion. The present study focuses on market orientation in small software firms that internationalize their operations rapidly in global software markets. It builds on qualitative data to illustrate how these companies develop their market-oriented product-market strategies during the process of increasing international commitment. It also shows how they manage their network relationships in order to be able to offer better customer service and to thrive in the fierce global competition. The study was conducted in the empirical context of Finnish small software companies, and the main data consists of interviews with top managers in these businesses. The interviews were designed to cover a minimum period of five years of the company's international operations, thus offering a retrospective in-depth perspective on market orientation, internationalization and partnerships in the given context. One particular focus is on less successfully internationalized software companies, and the challenges they face when approaching international markets. This study makes a significant contribution to the literature on market orientation for several reasons. First, building on data from the software industry, it clarifies the existing theory in the context of rapid internationalization and network relationships. Secondly, it provides a good body of evidence on market orientation in both successfully and less successfully internationalized companies, and identifies the key related differences between the two company groups. Thirdly, it highlights the importance of inter-firm networks in the rapid internationalization of small software firms, providing companies with important market knowledge and, in some cases, management challenges. Fourthly, this investigation clarifies market orientation in the context of different software-product strategies, thus, combining the perspectives of market orientation in both manufacturing and services. In sum, the results of the study are significant for both small software firms and public-policy makers since they shed light on the market-oriented managerial mindset and the market-information gathering and sharing processes that are needed in successful rapid internationalization.

Railway Wagon Market Analysis and New Multi-Purpose Wagon Solution for Freight Transports - Finnish Manufacturing Perspective

Rautateillä käytettävät tavaravaunut ovat vanhenemassa hyvin nopeasti; tämä koskee niin Venäjää, Suomea, Ruotsia kuin laajemminkin Eurooppaa. Venäjällä ja Euroopassa on käytössä runsaasti vaunuja, jotka ovat jo ylittäneet niille suositeltavan käyttöiän. Silti niitä käytetään kuljetuksissa, kun näitä korvaavia uusia vaunuja ei ole tarpeeksi saatavilla. Uusimmat vaunut ovat yleensä vaunuja vuokraavien yritysten tai uusien rautatieoperaattorien hankkimia - tämä koskee erityisesti Venäjää, jossa vaunuvuokraus on noussut erittäin suosituksi vaihtoehdoksi. Ennusteissa kerrotaan vaunupulan kasvavan ainakin vuoteen 2010 saakka. Jos rautateiden suosio rahtikuljetusmuotona kasvaa, niin voimistuva vaunukysyntä jatkuu huomattavan paljon pidemmän aikaa. Euroopan ja Venäjän vaunukannan tilanne näkyy myös sitä palvelevan konepajateollisuuden ongelmina - yleisesti ottaen alan eurooppalaiset yritykset ovat heikosti kannattavia ja niiden liikevaihto ei juuri kasva, venäläiset ja ukrainalaiset yritykset ovat olleet samassa tilanteessa, joskin aivan viime vuosina tilanne on osassa kääntynyt paremmaksi. Kun näiden maanosien yritysten liikevaihtoa, voittoa ja omistaja-arvoa verrataan yhdysvaltalaisiin kilpailijoihin, huomataan että jälkimmäisten suoriutuminen on huomattavan paljon parempaa, ja näillä yrityksillä on myös kyky maksaa osinkoja omistajilleen. Tutkimuksen tarkoituksena oli kehittää uuden tyyppinen kuljetusvaunu Suomen, Venäjän sekä mahdollisesti myös Kiinan väliseen liikenteeseen. Vaunutyypin tarkoituksena olisi kyetä toimimaan monikäyttöisenä, niin raaka-aineiden kuin konttienkin kuljetuksessa, tasapainottaen kuljetusmuotojen aiheuttamaa kuljetuspaino-ongelmaa. Kehitystyön pohjana käytimme yli 1000 venäläisen vaunutyypin tietokantaa, josta valitsimme Data Envelopment Analysis -menetelmällä soveliaimmat vaunut kontinkuljetukseen (lähemmin tarkastelimme n. 40 vaunutyyppiä), jättäen mahdollisimman vähän tyhjää tilaa junaan, mutta silti kyeten kantamaan valitun konttilastin. Kun kantokykyongelmia venäläisissä vaunuissa ei useinkaan ole, on vertailu tehtävissä tavarajunan pituuden ja kokonaispainon perusteella. Simuloituamme yhdistettyihin kuljetuksiin soveliasta vaunutyyppiä käytännössä löytyvässä kuljetusverkostossa (esim. raakapuuta Suomeen tai Kiinaan ja kontteja takaisin Venäjän suuntaan), huomasimme lyhemmän vaunupituuden sisältävän kustannusetua, erityisesti raakaainekuljetuksissa, mutta myös rajanylityspaikkojen mahdollisesti vähentyessä. Lyhempi vaunutyyppi on myös joustavampi erilaisten konttipituuksien suhteen (40 jalan kontin käyttö on yleistynyt viime vuosina). Työn lopuksi ehdotamme uuden vaunutyypin tuotantotavaksi verkostomaista lähestymistapaa, jossa osa vaunusta tehtäisiin Suomessa ja osa Venäjällä ja/tai Ukrainassa. Vaunutyypin tulisi olla rekisteröity Venäjälle, sillä silloin sitä voi käyttää Suomen ja Venäjän, kuten myös soveltuvin osin Venäjän ja Kiinan välisessä liikenteessä.

Aesthetic Breast Augmentation Mastopexy Followed by Post-surgical Pyoderma Gangrenosum (PSPG): Clinic, Treatment, and Review of the Literature.

INTRODUCTION: Pyoderma gangrenosum (PG) is a rare autoinflammatory neutrophilic ulcerative skin disease, often developing after a trauma or surgical wounds. In the literature there are several reports of post-surgical PG (PSPG) of the breast. The authors of this article experienced an impressive case of PSPG after an aesthetic breast augmentation mastopexy. PSPG is a rare but severe complication in this elective aesthetic surgical procedure. METHOD: A systematic review of the literature was performed, focusing on PSPG after aesthetic breast surgery (augmentation mammoplasty/mastopexy). The online databases Pubmed, Medline, and Cochrane were used and additionally a Google© search was conducted. We compared the data obtained from a systematic literature review to an index case of PSPG after esthetic augmentation mammoplasty. RESULTS: The literature search identified seven articles describing eight cases of PSPG after aesthetic breast surgery. In four of these cases augmentation mammoplasty had been carried out, in two cases mastopexy and in two cases augmentation mammoplasty and mastopexy (augmentation mastopexy). The patient we treated and describe in this paper underwent an augmentation mastopexy outside our clinic. Eight patients suffered from local disease, at the site of surgical wounds, one patient had disseminated disease. Leukocytosis was present in five cases (out of nine). Eight patients had received corticosteroid treatment, one patient refused such treatment. The duration of corticosteroid treatment was on average for 41 days (range 21-60 days). In all cases, the areola had been spared. Complete healing of PSPG was observed on average after 5 months (range 1.5 months-1 year). DISCUSSION: PSPG of the breast after aesthetic breast surgery is rare, but every plastic surgeon should consider this possibility, especially if skin disease develops post-surgery, mimicking wound infection that does not respond to broad-spectrum antibiotic treatment. CONCLUSION: Although the literature does not recommend this step, implant removal is recommended by the authors because bacterial wound infection normally cannot be ruled out definitely in the early stages of disease. Additional surgical intervention should be limited to the absolute necessary and performed only under adequate systemic immunosuppressive therapy. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

AA amyloidosis treated with tocilizumab: case series and updated literature review.

BACKGROUND: In published case reports, tocilizumab (TCZ) has shown good efficacy for AA amyloidosis in almost all patients. We investigated the efficacy and safety of TCZ in AA amyloidosis in a multicentre study of unselected cases. METHODS: We e-mailed rheumatology and internal medicine departments in France, Switzerland and North Africa by using the Club Rhumatismes Inflammation (CRI) network and the French TCZ registry, Registry RoAcTEmra (REGATE), to gather data on consecutive patients with histologically proven AA amyloidosis who had received at least one TCZ infusion. Efficacy was defined as a sustained decrease in proteinuria level and/or stable or improved glomerular filtration rate (GFR) and by TCZ maintenance. RESULTS: We collected 12 cases of AA amyloidosis treated with TCZ as monotherapy (mean age of patients 63 ± 16.2 years, amyloidosis duration 20.6 ± 31.3 months): eight patients had rheumatoid arthritis (RA), six with previous failure of anti-tumor necrosis factor α (anti-TNF-α) therapy. In total, 11 patients had renal involvement, with two already on hemodialysis (not included in the renal efficacy assessment). For the nine other patients, baseline GFR and proteinuria level were 53.6 ± 32.8 mL/min and 5 ± 3.3 g/24 h, respectively. The mean follow-up was 13.1 ± 11 months. TCZ was effective for six of the eight RA patients (87.5%) according to European League Against Rheumatism response criteria (four good and two moderate responders). As expected, C-reactive protein (CRP) level decreased with treatment for 11 patients. Renal amyloidosis (n = 9) progressed in three patients and was stabilized in three. Overall, three patients showed improvement, with sustained decrease in proteinuria level (42%, 82% and 96%). Baseline CRP level was higher in subsequent responders to TCZ than other patients (p = 0.02). Among the six RA patients with previous anti-TNF-α therapy, amyloidosis was ameliorated in one and stabilized in three. Three serious adverse events occurred (two diverticulitis and one major calciphylaxia due to renal failure). Finally, 7 of 12 (58%) patients continued TCZ. CONCLUSIONS: The efficacy of TCZ for AA amyloidosis varies depending on the inflammatory status at treatment onset. Discrepancies between our study of unselected consecutive patients and reported cases may be due to publication bias. These results support further prospective trials of TCZ for AA amyloidosis.

Use of amitriptyline for the treatment of chronic tension-type headache. Review of the literature

Amitriptyline is a tricyclic antidepressant, considered the treatment of choice for different types of chronic pain, including chronic myofascial pain. Its antinociceptive property is independent of its antidepressant effect. Although its analgesic mechanism is not precisely known, it is believed that the serotonin reuptake inhibition in the central nervous system plays a fundamental role in pain control. Although this medication is widely used in the prevention of chronic tension-type headache, few studies have investigated the efficacy of this treatment and the published results are contradictory. The objective of this article was to review the literature published on the use of amitriptyline in the prophylactic treatment of chronic tension-type headache, considering the level of scientific evidence of the different studies using the SORT criteria. From this review, 5 articles of evidence level 1, and another 5 articles of evidence level 2 were selected. Following analysis of the 10 studies, and in function of their scientific quality, a level A recommendation was made in favor of using amitriptyline in the treatment of chronic tension-type headache.

The use of tricyclic antidepressants in the treatment of temporomandibular joint disorders: systematic review of the literature of the last 20 years

Many therapies have been proposed for the management of temporomandibular disorders, including the use of different drugs. However, lack of knowledge about the mechanisms behind the pain associated with this pathology, and the fact that the studies carried out so far use highly disparate patient selection criteria, mean that results on the effectiveness of the different medications are inconclusive. This study makes a systematic review of the literature published on the use of tricyclic antidepressants for the treatment of temporomandibular disorders, using the SORT criteria (Strength of recommendation taxonomy) to consider the level of scientific evidence of the different studies. Following analysis of the articles, and in function of their scientific quality, a type B recommendation is given in favor of the use of tricyclic antidepressants for the treatment of temporomandibular disorders.

Prevalence of smoking among dentists in Catalonia - Spain (2006). Literature review of smoking cessation practices in the dental office

Objective: The objective of this study was to collect data on the prevalence of smokers among Catalonian dentists (by age and sex) and compare them with existing data on the general population, doctors, registered nurses and pharmacists. The overall prevalence of smokers in Catalonia (2006) was 34.5% of men and 24.3% of women. Data available on the prevalence of smoking among doctors (26.3% men and 22.1% women), pharmacists (19.8% men and 20.6% women) and registered nurses (34.1% men and 35.3% women) relates to the year 2002. Study design: In September 2006, Catalonian dentists (n=3,799) were asked about their habits in relation to tobacco in a self-administered questionnaire, on use and opinions with respect to dental amalgam. Five hundred and seventynine questionnaires were received, of which 538 answered the question on smoking (14.2% of the sample universe). Results: The prevalence of smokers among dentists is lower (24.9% of men and 18.4% of women) than in the general population and other healthcare professionals. In dentists in the age group between 25 and 34 years, the prevalence was 26.1% in men and 14.9% in women, while the prevalence in this age group in the general population was 43.6% and 37.1%, respectively. Conclusion: Catalonian dentists have a much lower prevalence of tobacco use than the general population and lower even than other healthcare professionals. Given that non-smoking healthcare professionals have better awareness for providing recommendations for smoking prevention and cessation, Catalonian dentists may be a valid group for performing this task for which there is scientific evidence.

Inverted ductal papilloma of the oral cavity secondary to lower lip trauma. A case report and literature review

Inverted ductal papilloma of the oral cavity is an infrequent benign neoplasm of papillary appearance that originates in the secretory duct of a salivary gland. The etiology is unknown, though some authors have related it to human papillomavirus (HPV) infection. We present the case of a 40-year-old woman with a tumor of the lower lip mucosa. Histopathological study of the lesion diagnosed inverted ductal papilloma of the oral cavity. Human papillomavirus DNA detection and typing based on tumor lesion DNA amplification and posterior hybridization, revealed no presence of viral DNA. The antecedents of trauma reported by the patient could have played an important role in the development of this tumor