Kysyntä-toimitusketjun synkronointi epävarman kysynnän ja tarjonnan toimintaympäristössä

Kysynnän ja tarjonnan epävarmuudet ovat nykyisin arkipäivää useilla toimialoilla. Elämme epävarmuuden suhteen ennen näkemättömiä aikoja, minkä on arvioitu jatkuvan myös tulevaisuudessa. Yritysten tilauskannat ovat lyhyitä, ja tilaukset viivästyvät tai peruuntuvat kokonaan. Toisaalta tarjonnan epävarmuudet aiheuttavat asiakasyrityksille haasteita esimerkiksi toimitusmyöhästymisten muodossa. Tuotannon ollessa hajaantunut verkostoihin yksittäisten yritysten toiminta ja päätökset vaikuttavat toisten verkostoyritysten toimintaan. Tämän takia epävarmuuden aiheuttamista muutoksista ja poikkeamista tulisi tiedottaa kumppaniyrityksiä, jotta kaikki pysyisivät samalla kellotaajuudella. Operatiivisen ja taktisen tiedon jakaminen on nykyisissä toimitusketjuissa jo arkipäivää, mutta yritysten välisistä rajapinnoista löytyy edelleen kehitettävää. Riittävästä ei kiinnitetä huomiota vastaanottajan kykyyn ja tapaan hyödyntää informaatiota – varsinkaan muutostilanteissa. Ajan/nopeuden ollessa yhä tärkeämpi kilpailutekijä informaation ajoituksella on kriittinen merkitys kysyntä-toimitusketjujen kokonaissuorituskykyyn. Toisin sanoen, millä ajanhetkellä tietoa tulisi jakaa, jotta kumppani pystyisi hyödyntämään saamaansa tietoa mahdollisimman hyvin. Kysyntä-toimitusketjun synkronoinnilla tarkoitetaan tässä väitöstutkimuksessa nimenomaan aikatekijään keskittymistä yritysten välisessä päätöksenteossa ja informaation jakamisessa toimitusketjun kokonaissuorituskyvyn parantamiseksi. Tutkimus kytkeytyy toimitusketjukoordinoinnin tieteelliseen keskusteluun. Koordinointiteorian keskeinen osa ovat riippuvuussuhteet, joita johdetaan koordinointimekanismien avulla. Kysyntätoimitusketjun synkronointia on mallinnettu aikaisemmin VOP-OPP-mallin (Value Offering Point – Order Penetration Point) ja sen johdannaisten avulla. Näissä malleissa asiakasyrityksen kysyntäketju ja toimittajayrityksen toimitusketju ovat keskinäisessä riippuvuussuhteessa, jota johdetaan päätöksenteon synkronoinnin ja informaation jakamisen koordinointimekanismeilla. VOP-OPP-malli johdannaisineen eivät kuitenkaan huomioi epävarman toimintaympäristön vaikutuksia synkronointiin. Näissä malleissa informaation ainoana laatudimensiona tarkasteltava aikatekijä on liian kapea-alainen näkökulma synkronointiin epävarmassa ympäristössä. Lisäksi nämä mallit keskittyvät vain yksisuuntaiseen, kysyntälähtöiseen, synkronointiin jättäen huomioimatta tarjontalähtöisen synkronoinnin. Aikatekijä- ja kokonaissuorituskykypainotustensa takia VOP-OPP-malli tarjosi kuitenkin hyvän lähtöfilosofian uusien synkronointimallien kehittämiseen. Väitöstutkimus toteutettiin hypoteettis-deduktiivisena tapaustutkimuksena, jossa ensin luotiin kirjallisuuden perusteella uudet teoreettiset synkronointimalliehdotukset. Tämän jälkeen ehdotusten toimivuutta arvioitiin käytännön kysyntä-toimitusketjuissa. Tutkimuksen uutuusarvo liittyy kysyntä-toimitusketjun synkronoinnin keskeisten piirteiden systeemiseen mallintamiseen epävarmassa toimintaympäristössä. Kontribuutiona esitetään kysyntä-toimitusketjun synkronoinnin moniulotteinen kokonaismalli, joka sisältää koordinointimekanismeina päätöksenteon synkronoinnin, informaation läpinäkyvyyden sekä asiakas- ja toimittajapään joustot. Tiedon vaihtoa mallissa tarkastellaan kaksisuuntaisesti – kysyntä- ja tarjontalähtöisesti. Informaation laatudimensioina mallissa ovat informaation ajoitus, luotettavuus ja tarkkuus. Kokonaismalli sisältää kolme alimallia: Demand Visibility Point – Demand Penetration Point (DVP-DPP) on kysyntälähtöisen synkronoinnin malli, Supply Visibility Point – Supply Information Penetration Point (SVP-SIPP) on tarjontalähtöisen synkronoinnin malli ja Integroitu DVP-DPP - SVP-SIPP-malli kytkee edellä mainitut mallit toisiinsa. Näissä alimalleissa informaation eri luokkia ovat tilausta edeltävä, tilaukseen liittyvä, tilauksen jälkeinen ja sovitun toimitusajankohdan jälkeinen kysyntä- ja tarjontatieto. Käytännön hyödyntämisen näkökulmasta mallit toimivat ns. mentaalitason koordinointimekanismeina, joiden tarkoitus on herättää toimitusketjukumppanit tavoittelemaan kokonaissuorituskyvyn parantamista oman edun tavoittelemisen sijasta. Tutkimuksen päärajoitteena on sen keskittyminen ainoastaan kahdenvälisiin yhteistyösuhteisiin, mikä tarjoaa nykyisessä verkostoituneessa toimintaympäristössä varsin kapean kuvan käytännön synkronointihaasteisiin.

In search of information systems value : a case study of the EHR benefits realisation efforts of three Swedish hospitals.

The Swedish public health care organisation could very well be undergoing its most significant change since its specialisation during the late 19th and early 20th century. At the heart of this change is a move from using manual patient journals to electronic health records (EHR). EHR are complex integrated organisational wide information systems (IS) that promise great benefits and value as well as presenting great challenges to the organisation. The Swedish public health care is not the first organisation to implement integrated IS, and by no means alone in their quest for realising the potential benefits and value that it has to offer. As organisations invest in IS they embark on a journey of value-creation and capture. A journey where a costbased approach towards their IS-investments is replaced with a value-centric focus, and where the main challenges lie in the practical day-to-day task of finding ways to intertwine technology, people and business processes. This has however proven to be a problematic task. The problematic situation arises from a shift of perspective regarding how to manage IS in order to gain value. This is a shift from technology delivery to benefits delivery; from an ISimplementation plan to a change management plan. The shift gives rise to challenges related to the inability of IS and the elusiveness of value. As a response to these challenges the field of IS-benefits management has emerged offering a framework and a process in order to better understand and formalise benefits realisation activities. In this thesis the benefits realisation efforts of three Swedish hospitals within the same county council are studied. The thesis focuses on the participants of benefits analysis projects; their perceptions, judgments, negotiations and descriptions of potential benefits. The purpose is to address the process where organisations seek to identify which potential IS-benefits to pursue and realise, this in order to better understand what affects the process, so that realisation actions of potential IS-benefits could be supported. A qualitative case study research design is adopted and provides a framework for sample selection, data collection, and data analysis. It also provides a framework for discussions of validity, reliability and generalizability. Findings displayed a benefits fluctuation, which showed that participants’ perception of what constituted potential benefits and value changed throughout the formal benefits management process. Issues like structure, knowledge, expectation and experience affected perception differently, and this in the end changed the amount and composition of potential benefits and value. Five dimensions of benefits judgment were identified and used by participants when finding accommodations of potential benefits and value to pursue. Identified dimensions affected participants’ perceptions, which in turn affected the amount and composition of potential benefits. During the formal benefits management process participants shifted between judgment dimensions. These movements emerged through debates and interactions between participants. Judgments based on what was perceived as expected due to one’s role and perceived best for the organisation as a whole were the two dominant benefits judgment dimensions. A benefits negotiation was identified. Negotiations were divided into two main categories, rational and irrational, depending on participants’ drive when initiating and participating in negotiations. In each category three different types of negotiations were identified having different characteristics and generating different outcomes. There was also a benefits negotiation process identified that displayed management challenges corresponding to its five phases. A discrepancy was also found between how IS-benefits are spoken of and how actions of IS benefits realisation are understood. This was a discrepancy between an evaluation and a realisation focus towards IS value creation. An evaluation focus described IS-benefits as well-defined and measurable effects and a realisation focus spoke of establishing and managing an on-going place of value creation. The notion of valuescape was introduced in order to describe and support the understanding of IS value creation. Valuescape corresponded to a realisation focus and outlined a value configuration consisting of activities, logic, structure, drivers and role of IS.

Factors affecting Cyperus difformis seed germination and seedling emergence

Specific knowledge about the dormancy, germination, and emergence patterns of weed species aids the development of integrated management strategies. Laboratory studies were conducted to determine the effect of several environmental factors on seed germination and seedling emergence of Cyperus difformis. Germination of freshly harvested seeds was inhibited by darkness; however, when seeds were subsequently transferred to complete light they germinated readily. Our results showed that 2 wk of cold stratification overcome the light requirement for germination. Seeds of C. difformis were able to germinate over a broad range of temperatures (25/15, 30/20, 35/25, and 40/30 ºC day/night). The response of germination rate to temperature was described as a non-linear function. Based on model outputs, the base, the optimum and the ceiling temperatures were estimated as 14.81, 37.72 and 45 ºC, respectively. A temperature of 120 ºC for a 5 min was required to inhibit 50% of maximum germination. The osmotic potential and salinity required for 50% inhibition of maximum germination were -0.47 MPa and 135.57 mM, respectively. High percentage of seed germination (89%) was observed at pH=6 and decreased to 12% at alkaline medium (pH 9) pH. Seeds sown on the soil surface gave the greatest percentage of seedling emergence, and no seedlings emerged from seeds buried in soil at depths of 1 cm.

Target audience and message alignment for integrated marketing communication of luxury products: entering the Chinese market

The purpose of this study is to identify opportunities to match marketing communication message strategies with the target audience characteristics in the Chinese luxury market entry context. Therefore, consumer behaviour and psychographic marketing segmentation fields are being reviewed in a holistic view in order to identify the similarities and connection points. Through the analysis of the messages in advertisements placed in a certain luxury and fine living magazine, message creation strategies are being anticipated.

Anaesthesia and Pain Management for Use in Orthopaedic Day Surgery

Day surgery has gained a large popularity during the last decades. In Finland, 57% of the elective procedures, and 50% at Turku University Hospital, were already conducted on day basis during 2012. The steady growth of day surgery is mostly due to an increased safety in perioperative care and cost-effectiveness. The development of surgical techniques and anaesthetic methods has advanced the modern day surgery and extended the repertory of the procedures for use in day surgery operations. Day surgery also offers certain benefits like reduced risk for hospital-related infections, stress and confusion. Patient satisfaction, regarding several issues, is high. Most concerns and complaints are related to postoperative pain, nausea and vomiting pain and nausea. Pain can hamper recovery and pain management is a crucial factor for hospital discharge. Appropriate pain treatment is effective, safe, easy and economical. A procedure-specific approach and an individually planned, multimodal analgesia should be the basis of modern pain management. The main aim of this thesis was to evaluate the effectiveness and safety of anaesthetic technique and methods in pain treatment of orthopaedic day case surgery, and following conclusions were made. Unilateral spinal block was achieved using hyperbaric bupivacaine with a small dose of clonidine but clonidine prolonged the block. Continuous subacromial bupivacaine was found to be safe but conferring only moderate efficacy in pain care after shoulder arthroscopy. Transdermal fentanyl, 12 g/h, as part of multimodal analgesia, offered a safe and easy option to pain management in this patient group. However, after forefoot surgery, it did not reduce pain any further. In general, pain scores in all patient groups were low and the need for rescue opioid moderate.

Monosodium glutamate (MSG)-obese rats develop glucose intolerance and insulin resistance to peripheral glucose uptake

Different levels of insulin sensitivity have been described in several animal models of obesity as well as in humans. Monosodium glutamate (MSG)-obese mice were considered not to be insulin resistant from data obtained in oral glucose tolerance tests. To reevaluate insulin resistance by the intravenous glucose tolerance test (IVGTT) and by the clamp technique, newborn male Wistar rats (N = 20) were injected 5 times, every other day, with 4 g/kg MSG (N = 10) or saline (control; N = 10) during the first 10 days of age. At 3 months, the IVGTT was performed by injecting glucose (0.75 g/kg) through the jugular vein into freely moving rats. During euglycemic clamping plasma insulin levels were increased by infusing 3 mU . kg-1 . min-1 of regular insulin until a steady-state plateau was achieved. The basal blood glucose concentration did not differ between the two experimental groups. After the glucose load, increased values of glycemia (P<0.001) in MSG-obese rats occurred at minute 4 and from minute 16 to minute 32. These results indicate impaired glucose tolerance. Basal plasma insulin levels were 39.9 ± 4 µU/ml in control and 66.4 ± 5.3 µU/ml in MSG-obese rats. The mean post-glucose area increase of insulin was 111% higher in MSG-obese than in control rats. When insulinemia was clamped at 102 or 133 µU/ml in control and MSG rats, respectively, the corresponding glucose infusion rate necessary to maintain euglycemia was 17.3 ± 0.8 mg . kg-1 . min-1 for control rats while 2.1 ± 0.3 mg . kg-1 . min-1 was sufficient for MSG-obese rats. The 2-h integrated area for total glucose metabolized, in mg . min . dl-1, was 13.7 ± 2.3 vs 3.3 ± 0.5 for control and MSG rats, respectively. These data demonstrate that MSG-obese rats develop insulin resistance to peripheral glucose uptake

Biogas production in regional integrated biodegradable waste treatment – Possibilities for improving energy performance and reducing GHG emissions

The greatest threat that the biodegradable waste causes on the environment is the methane produced in landfills by the decomposition of this waste. The Landfill Directive (1999/31/EC) aims to reduce the landfilling of biodegradable waste. In Finland, 31% of biodegradable municipal waste ended up into landfills in 2012. The pressure of reducing disposing into landfills is greatly increased by the forthcoming landfill ban on biodegradable waste in Finland. There is a need to discuss the need for increasing the utilization of biodegradable waste in regional renewable energy production to utilize the waste in a way that allows the best possibilities to reduce GHG emissions. The objectives of the thesis are: (1) to find important factors affecting renewable energy recovery possibilities from biodegradable waste, (2) to determine the main factors affecting the GHG balance of biogas production system and how to improve it and (3) to find ways to define energy performance of biogas production systems and what affects it. According to the thesis, the most important factors affecting the regional renewable energy possibilities from biodegradable waste are: the amount of available feedstock, properties of feedstock, selected utilization technologies, demand of energy and material products and the economic situation of utilizing the feedstocks. The biogas production by anaerobic digestion was seen as the main technology for utilizing biodegradable waste in agriculturally dense areas. The main reason for this is that manure was seen as the main feedstock, and it can be best utilized with anaerobic digestion, which can produce renewable energy while maintaining the spreading of nutrients on arable land. Biogas plants should be located close to the heat demand that would be enough to receive the produced heat also in the summer months and located close to the agricultural area where the digestate could be utilized. Another option for biogas use is to upgrade it to biomethane, which would require a location close to the natural gas grid. The most attractive masses for biogas production are municipal and industrial biodegradable waste because of gate fees the plant receives from them can provide over 80% of the income. On the other hand, directing gate fee masses for small-scale biogas plants could make dispersed biogas production more economical. In addition, the combustion of dry agricultural waste such as straw would provide a greater energy amount than utilizing them by anaerobic digestion. The complete energy performance assessment of biogas production system requires the use of more than one system boundary. These can then be used in calculating output–input ratios of biogas production, biogas plant, biogas utilization and biogas production system, which can be used to analyze different parts of the biogas production chain. At the moment, it is difficult to compare different biogas plants since there is a wide variation of definitions for energy performance of biogas production. A more consistent way of analyzing energy performance would allow comparing biogas plants with each other and other recovery systems and finding possible locations for further improvement. Both from the GHG emission balance and energy performance point of view, the energy consumption at the biogas plant was the most significant factor. Renewable energy use to fulfil the parasitic energy demand at the plant would be the most efficient way to reduce the GHG emissions at the plant. The GHG emission reductions could be increased by upgrading biogas to biomethane and displacing natural gas or petrol use in cars when compared to biogas CHP production. The emission reductions from displacing mineral fertilizers with digestate were seen less significant, and the greater N2O emissions from spreading digestate might surpass the emission reductions from displacing mineral fertilizers.

Tacrolimus (FK506) reduces ischemia-induced hippocampal damage in rats: a 7- and 30-day study

The neuroprotective effect of the immunosuppressant agent FK506 was evaluated in rats after brain ischemia induced for 15 min in the 4-vessel occlusion model. In the first experimental series, single doses of 1.0, 3.0 or 6.0 mg FK506/kg were given intravenously (iv) immediately after ischemia. In the second series, FK506 (1.0 mg/kg) was given iv at the beginning of reperfusion, followed by doses applied intraperitoneally (ip) 6, 24, 48, and 72 h post-ischemia. The same protocol was used in the third series except that all 5 doses were given iv. Damage to the hippocampal field CA1 was assessed 7 or 30 days post-ischemia on three different stereotaxic planes along the septotemporal axis of the hippocampus. Ischemia caused marked neurodegeneration on all planes (P<0.001). FK506 failed to provide neuroprotection to CA1 both when applied iv as a single dose of 1.0, 3.0 or 6.0 mg/kg (experiment 1), and after five iv injections of 1.0 mg/kg (experiment 3). In contrast, the repeated administration of FK506 combining iv plus ip administration reduced CA1 cell death on all stereotaxic planes both 7 and 30 days post-ischemia (experiment 2; P<=0.01). Compared to vehicle alone, FK506 reduced rectal temperature in a dose-dependent manner (P<=0.05); however, this effect did not alter normothermia (37ºC). FK506 reduced ischemic brain damage, an effect sustained over time and apparently dependent on repeated doses and on delivery route. The present data extend previous findings on the rat 4-vessel occlusion model, further supporting the possible use of FK506 in the treatment of ischemic brain damage.

Noroviruses associated with acute gastroenteritis in a children's day care facility in Rio de Janeiro, Brazil

Noroviruses (Norwalk-like viruses) are an important cause of gastroenteritis worldwide. They are the most common cause of outbreaks of gastroenteritis in the adult population and occur in nursing homes for the elderly, geriatric wards, medical wards, and in hotel and restaurant settings. Food-borne outbreaks have also occurred following consumption of contaminated oysters. This study describes the application of a reverse transcription-polymerase chain reaction (RT-PCR) assay using random primers (PdN6) and specific Ni and E3 primers, directed at a small region of the RNA-dependent RNA polymerase-coding region of the norovirus genome, and DNA sequencing for the detection and preliminary characterisation of noroviruses in outbreaks of gastroenteritis in children in Brazil. The outbreak samples were collected from children <5 years of age at the Bertha Lutz children's day care facility at Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, that occurred between 1996 and 1998, where no pathogen had been identified. At the Bertha Lutz day care center facility, only Fiocruz's employee children are provided for, and they come from different social, economic and cultural backgrounds. Three distinct genogroup II strains were detected in three outbreaks in 1997/98 and were most closely related to genotypes GII-3 (Mexico virus) and GII-4 (Grimsby virus), both of which have been detected in paediatric and adult outbreaks of gastroenteritis worldwide.

Integrated energy storage tank for large scale power-to-gas applications

The global interest towards renewable energy production such as wind and solar energy is increasing, which in turn calls for new energy storage concepts due to the larger share of intermittent energy production. Power-to-gas solutions can be utilized to convert surplus electricity to chemical energy which can be stored for extended periods of time. The energy storage concept explored in this thesis is an integrated energy storage tank connected to an oxy-fuel combustion plant. Using this approach, flue gases from the plant could be fed directly into the storage tank and later converted into synthetic natural gas by utilizing electrolysis-methanation route. This work utilizes computational fluid dynamics to model the desublimation of carbon dioxide inside a storage tank containing cryogenic liquid, such as liquefied natural gas. Numerical modelling enables the evaluation of the transient flow patterns caused by the desublimation, as well as general fluid behaviour inside the tank. Based on simulations the stability of the cryogenic storage and the magnitude of the key parameters can be evaluated.

Integration of biofuel production. How pyrolysis and torrefaction can be integrated

The main goal of this work is to clarify the idea of two thermochemical conversion processes of biomass - pyrolysis and torrefaction and to identify possible ways how and where exactly these processes can be integrated. Integration into CHP power plant process was chosen as one of the most promising ways. Multiple product development was determined by means of this integration concept. The analysis of the possible pros and cons was made based on some experimental data collected from the previous studies related to the topic of my work. In addition, one real integrated case was represented in the last part of the work. Finally, to highlight the main idea brief summarizing was done.

Effect of the time-of-day of training on explicit memory

Studies have shown a time-of-day of training effect on long-term explicit memory with a greater effect being shown in the afternoon than in the morning. However, these studies did not control the chronotype variable. Therefore, the purpose of this study was to assess if the time-of-day effect on explicit memory would continue if this variable were controlled, in addition to identifying the occurrence of a possible synchronic effect. A total of 68 undergraduates were classified as morning, intermediate, or afternoon types. The subjects listened to a list of 10 words during the training phase and immediately performed a recognition task, a procedure which they repeated twice. One week later, they underwent an unannounced recognition test. The target list and the distractor words were the same in all series. The subjects were allocated to two groups according to acquisition time: a morning group (N = 32), and an afternoon group (N = 36). One week later, some of the subjects in each of these groups were subjected to a test in the morning (N = 35) or in the afternoon (N = 33). The groups had similar chronotypes. Long-term explicit memory performance was not affected by test time-of-day or by chronotype. However, there was a training time-of-day effect [F (1,56) = 53.667; P = 0.009] with better performance for those who trained in the afternoon. Our data indicated that the advantage of training in the afternoon for long-term memory performance does not depend on chronotype and also that this performance is not affected by the synchronic effect.

Relationship between Brazilian airline pilot errors and time of day

Flight safety is one of the most important and frequently discussed issues in aviation. Recent accident inquiries have raised questions as to how the work of flight crews is organized and the extent to which these conditions may have been contributing factors to accidents. Fatigue is based on physiologic limitations, which are reflected in performance deficits. The purpose of the present study was to provide an analysis of the periods of the day in which pilots working for a commercial airline presented major errors. Errors made by 515 captains and 472 copilots were analyzed using data from flight operation quality assurance systems. To analyze the times of day (shifts) during which incidents occurred, we divided the light-dark cycle (24:00) in four periods: morning, afternoon, night, and early morning. The differences of risk during the day were reported as the ratio of morning to afternoon, morning to night and morning to early morning error rates. For the purposes of this research, level 3 events alone were taken into account, since these were the most serious in which company operational limits were exceeded or when established procedures were not followed. According to airline flight schedules, 35% of flights take place in the morning period, 32% in the afternoon, 26% at night, and 7% in the early morning. Data showed that the risk of errors increased by almost 50% in the early morning relative to the morning period (ratio of 1:1.46). For the period of the afternoon, the ratio was 1:1.04 and for the night a ratio of 1:1.05 was found. These results showed that the period of the early morning represented a greater risk of attention problems and fatigue.

Long-term efficacy of a rural community-based integrated intervention for prevention and management of chronic obstructive pulmonary disease: a cluster randomized controlled trial in China's rural areas

This study aimed to assess the efficacy of a rural community-based integrated intervention for early prevention and management of chronic obstructive pulmonary disease (COPD) in China. This 18-year cluster-randomized controlled trial encompassing 15 villages included 1008 patients (454 men and 40 women in the intervention group [mean age, 54 ± 10 years]; 482 men and 32 women in the control group [mean age, 53 ± 10 years]) with confirmed COPD or at risk for COPD. Villages were randomly assigned to the intervention or the control group, and study participants residing within the villages received treatment accordingly. Intervention group patients took part in a program that included systematic health education, smoking cessation counseling, and education on management of COPD. Control group patients received usual care. The groups were compared after 18 years regarding the incidence of COPD, decline in lung function, and mortality of COPD. COPD incidence was lower in the intervention group than in the control group (10% vs 16%, <0.05). A decline in lung function was also significantly delayed in the intervention group compared to the control group of COPD and high-risk patients. The intervention group showed significant improvement in smoking cessation compared with the control group, and smokers in the intervention group had lower smoking indices than in the control group (350 vs 450, <0.05). The intervention group also had a significantly lower cumulative COPD-related death rate than the control group (37% vs 47%, <0.05). A rural community-based integrated intervention is effective in reducing the incidence of COPD among those at risk, delaying a decline in lung function in COPD patients and those at risk, and reducing mortality of COPD.