Patient education to support self-management of patients with mental illness

This study explores areas which need to be improved to develop the quality of patient education to support self-management of patients with mental illness in psychiatric hospitals. The study was conducted in five phases during the period 2000 – 2007. First, patients‘ (n = 313) satisfaction with patient education were investigated. Second, patients' (n = 51) experiences of patient education were explored. Third, a national survey was conducted to investigate realisation of patient education from the staff (n = 55) viewpoint. Fourth, outcomes of patient education were investigated by evaluating the impacts of different patient education methods on patients‘ (n = 311) attitudes towards medication, knowledge level and importance of information. Fifth, patients‘ (n = 16) perceptions of different patient education methods were explored. Patients reported poor satisfaction with patient education (Phase I), and they have considerable need to receive information during their hospital stay (Phase II). Described by staff, the content of patient education covered almost all informational areas investigated. However, discrepancies related to the realisation of patient education were found. (Phase III.) Evaluation of different patient education methods indicate that patients derived benefits from structured patient education with supportive methods (Phase IV) and patients also perceived that these methods supported their information receiving (Phase V). In order to improve the quality of patient education to support self-management of patients with mental illness patient education should be systematically and individually provided to all patients by using different educational methods. Realisation of this should be ensured by providing written instructions, improving nurses‘ knowledge and skills as well ensuring operating conditions.

Quality management of outsourcing welded structure: case China

For any international companies who wish to enter the Chinese market, quality is base on the fundamental. The companies are coming to realize the importance of quality gradually, thus companies have been put the quality problems on the agenda. The competitiveness of companies comes from quality. Quality is the key to success, and it can decide that the companies can be accepted or eliminated by the market. Due to the obvious benefits, the demand of the method of how to achieve high quality of product keeps growing. During achieving the high quality process, the main troubles come from the impact between Eastern and Western culture. Chinese culture which is different with Western one have lasted as long as five thousand years. Such a culture deeply rooted in the hearts of Chinese people, and effected generation after generation of Chinese people's working style and ways of thinking. This thesis determines how to find a good fit point between Eastern and Western culture. Doing right thing by the right way. The nature of improving quality is improving management level in fact. "How to manage, who should be managed", the thesis explains the basic and best option to achieve those. It describes three-dimension-style management to monitoring the working process. This kind of management style can inspect production process from horizontal and vertical direction. In this management way, it defines effective evaluation system to every subcontractor, and makes the companies to achieve the ultimate goal - satisfy quality. Because of the importance of human factor, the thesis determines the range of training of the inspector and welder due to the current situation of China. The results show that in order to reach reliable training effective evaluation, not only the quality of the human but also the ultimate goal of product quality.

Parents as Pain Killers in the Pain Management of Preterm Infants

Vanhemmat keskoslasten kivun lievittäjinä Tutkimuksen tarkoituksena oli kehittää uusi kivunlievitysmenetelmä, Vanhempien käsikapalo, keskoslasten kivunhoitoon vastasyntyneiden teho-osastolla. Vanhempien käsikapalon tehokkuutta verrattiin kahdessa satunnaistetussa kontrolloidussa crossover-tutkimusasetelmassa ei-lääkkeelliseen näyttöön perustuvaan hoitoon (P.O. glukoosiliuos), lääkkeelliseen menetelmään (I.V. oksikodoni) ja lumeeseen (P.O. vesi) tai kontrolli hoitoon kantapääpiston ja hengitysteiden imemisen aikana. Lisäksi mitattiin kivunhoidon lyhytaikaisia sivuvaikutuksia (hapetuksen- ja pulssinlasku) ja pidempiaikaisia vaikutuksia uneen. Tutkittujen lasten ikä oli 28 raskausviikkoa (n = 20) ja 28 1/7 (n = 20). Toimenpidekipua arvioitiin Premature Infant Pain Profile (PIPP) -kipumittarilla. Interventioiden jälkeen unen rakenne analysoitiin 13 tunnin polysomnografia-rekisteröinneistä. Viimeisessä vaiheessa haastateltiin äitejä (n = 23), jotka olivat käyttäneet vanhempien käsikapaloa 2–4 viikkoa vastasyntyneiden teho-osastolla, strukturoidulla the Clinical Interview for Parents of High-Risk Infants -haastattelulla, johon oli lisätty kysymyksiä lapsen kivunhoidosta. Kantapääpiston aikana PIPP–pisteet olivat merkitsevästi matalampia P.O. glukoosiliuoksella (ka 4,85 ± 1,73, p ≤ 0,001) ja vanhempien käsikapalolla (ka 5,20 ± 1,70, p = 0,004) verrattuna lumeeseen (ka 7,05 ± 2,16). Hengitysteiden imemisen yhteydessä PIPP–pisteet olivat matalampia P.O. glukoosiliuoksella (ka 11,05 ± 2,31, p = 0,014) ja vanhempien käsikapalolla (ka 11,25 ± 2,47, p = 0,034) verrattuna lumeeseen (ka 12,40 ± 2,06). Oksikodonin teho oli verrattavissa lumeeseen kummankin toimenpiteen aikana. P.O. glukoosiliuoksen (21,3 %) ja lumeen (12,5 %) annosteluun liittyi merkittävästi enemmän lyhytaikaisia sivuvaikutuksia verrattuna oksikodoniin (5 %) tai vanhempien käsikapaloon (5 %). Oksikodoni muutti keskoslasten unen rakennetta vähentämällä merkittävästi aktiivisen unen määrää verrattuna muihin hoitoihin. Vanhemmat suhtautuivat positiivisesti käsikapalon käyttöön. Äitien osallistuminen kivunhoitoon voitiin jaotella kolmeen eri tyylin, jotka selittyivät äidin kiintymyksen tunteilla ja lapsen tehohoitoon liittyvällä stressillä. Vanhempien käsikapalo on suositeltavampi lyhyen toimenpidekivun lievittäjä kuin P.O. glukoosiliuos tai I.V. oksikodoni, kun tehokkuus, turvallisuus ja perhe otetaan huomioon.

Management of interdependency in project portfolio

Project management has evolved in recent decades. Project portfolio management, together with multi project management, is an emerging area in the project management field in practice, and correspondingly in academic research and forums. In multi project management, projects cannot be handled isolated from each other, as they often have interdependencies that have to be taken into account. If the interdependencies between projects are evaluated during the selection process, the success rate of the project portfolio is increased. Interdependencies can be human resources, technological, and/or market based. Despite of the fact that interdependency as a phenomenon has roots in the 1960s and is related to famous management theories, it has not been much studied, although in practice most companies use it to great extent. There exists some research on interdependency, but prior publications have not emphasized the phenomenon per se, because a practical orientation practitioner techniques prevails in the literature. This research applies the method triangulation, electronic surveys and multiple case study. The research concentrates on small to large companies in Estonia and Finland, mainly in construction, engineering, ICT, and machinery industries. The literature review reveals that interdependencies are deeply involved in R&D and innovation. Survey analysis shows that companies are aware of interdependency issues in general, but they i have lack of detailed knowledge to use it thoroughly. Empirical evidence also indicates that interdependency techniques influence the success rate and other efficiency aspects to different extents. There are a lot of similarities in interdependency related managerial issues in companies of varying sizes and countries in Northern Europe. Differences found in the study are for instance the fact that smaller companies face more difficulties in implementing and evaluating interdependency procedures. Country differences between Estonia and Finland stem from working solutions to manage interdependencies on a daily basis.historical and cultural reasons, such as the special features of a transition country compared to a mature country. An overview of the dominant problems, best practices, and commonly used techniques associated with interdependency is provided in the study. Empirical findings show that many interdependency techniques are not used in practice. A multiple case study was performed in the study to find out how interdependencies are managed in real life on a daily basis. The results show that interdependencies are mostly managed in an informal manner. A description of managing the interdependencies and implementation procedures is given. Interdependency procedures are hard to implement, especially in smaller companies. Companies have difficulties in implementing interdependency procedures and evaluating them. The study contains detailed results on how companies have implemented working solutions to manage interdependencies on a daily basis

Management of crotalaria and pigeon pea for control of yam nematode diseases

Management of plant-parasitic nematodes with the use of nematicides has not been recommended for small farmers that grow yam in the Northeastern region of Brazil, due to its high cost and residue toxicity. The use of plants with antagonistic effect to nematodes and green manure which improves soil chemical, physical and biological characteristics can be a viable and low cost alternative to control parasitic nematodes. This work aimed to evaluate the effect of crotalaria (Crotalaria juncea) and pigeon pea (Cajanus cajan) plants on the control of yam nematodes. Three experiments were carried out. The first was conducted under in vitro conditions to evaluate the nematostatic and nematicide effect of extracts from fresh and dry matter of the above ground parts of crotalaria, pigeon pea, and the combination of both. The second experiment was carried out under greenhouse conditions to evaluate the effect of soil amendment with crotalaria, pigeon pea, and the combination of both in the infectivity of Scutellonema bradys, using tomato plants as the host plant. The third experiment was conducted under field conditions to evaluate the effect of crotalaria, pigeon pea, and the combination of both, cultivated between yam planting rows and incorporated to soil surface, on yam nematodes. The aqueous extract obtained form fresh matter of crotalaria had a nematicide effect of 100% for S. bradys. Extracts from dry matter of both crotalaria and pigeon pea did not have any nematicide effect, but had a nematostatic effect. Incorporation of crotalaria to soil inhibited infectivity of S. bradys in tomato seedlings. These results showed that planting crotalaria alone or in combination with pigeon pea, between the yam planting rows, is an efficient method for controlling S. bradys and Rotylenchulus reniformis associated with yams. Crotalaria can be used for controlling these plant-parasitic nematodes in soil.

Algorithmic Solutions for Combinatorial Problems in Resource Management of Manufacturing Environments

This thesis studies the use of heuristic algorithms in a number of combinatorial problems that occur in various resource constrained environments. Such problems occur, for example, in manufacturing, where a restricted number of resources (tools, machines, feeder slots) are needed to perform some operations. Many of these problems turn out to be computationally intractable, and heuristic algorithms are used to provide efficient, yet sub-optimal solutions. The main goal of the present study is to build upon existing methods to create new heuristics that provide improved solutions for some of these problems. All of these problems occur in practice, and one of the motivations of our study was the request for improvements from industrial sources. We approach three different resource constrained problems. The first is the tool switching and loading problem, and occurs especially in the assembly of printed circuit boards. This problem has to be solved when an efficient, yet small primary storage is used to access resources (tools) from a less efficient (but unlimited) secondary storage area. We study various forms of the problem and provide improved heuristics for its solution. Second, the nozzle assignment problem is concerned with selecting a suitable set of vacuum nozzles for the arms of a robotic assembly machine. It turns out that this is a specialized formulation of the MINMAX resource allocation formulation of the apportionment problem and it can be solved efficiently and optimally. We construct an exact algorithm specialized for the nozzle selection and provide a proof of its optimality. Third, the problem of feeder assignment and component tape construction occurs when electronic components are inserted and certain component types cause tape movement delays that can significantly impact the efficiency of printed circuit board assembly. Here, careful selection of component slots in the feeder improves the tape movement speed. We provide a formal proof that this problem is of the same complexity as the turnpike problem (a well studied geometric optimization problem), and provide a heuristic algorithm for this problem.

MODELING A COMPUTER APPLICATION FOR MANAGEMENT OF MAINTENANCE ACTIVITIES OF UNPAVED ROADS

ABSTRACTThis study presents a contribution to the modeling of a computer application employing a method of serviceability performance for unpaved roads, aiming the management of maintenance/restoration activities of the primary surface layer. The proposed methodology consisted of field inspections during dry (April to September) and rainy (October to March) periods, during which objective evaluations were performed to survey of defects and their densities and degrees of severity. To aid the functional classification of analyzed road sections and the determination of the defect with major influence on the serviceability of these roads, the method of serviceability performance proposed by Silva (2009)was implemented in the Visual Basic for Applications (VBA) language in Microsoft Excel software. With the use of the computer application proposed it was possible to identify among the defects analyzed in field, through the index of serviceability of the sampling unit per defect type (ISUdef), which one had the greatest influence on determining the relative serviceability index per road section (IST). The results allow us to conclude that the computer application Road achieved satisfactory results, since the objective evaluation criteria applied to road sections denotes consistency regarding their serviceability.

Management of commercial property derived risks in the market context of the Russian Federation

The objective of the thesis is to examine the current state of risk management and to determine an appropriate risk management policy for commercial property derived risks in the Russian branch of a Finnish retail trade company. The employed research methodologies are comparative in-depth interviews and empirical value at risk analysis, including portfolio risk decomposition to determine the inter-currency characteristics. For a multinational retail trade company, the commercial property derived risks open up as a diverse combination of financial and non-financial risks with four distinctive interest groups. The research results indicate that geographical diversification across currency regimes provides diversification benefits. The Russian ruble is the most significant single risk component when considering the net investments outside the euro-zone. Decreasing the Russian ruble and Swedish krona exposures are the most effective methods to reduce translation derived risk. Exchange rate volatility varies over time according to idiosyncratic currency regime characteristics, and cost-effective risk management requires comprehensive analysis of the business environment. Profound and proactive risk management methods are found to be pivotal for companies with cross-border operations in order to succeed among international competitors.

Innovation management of biorefineries in Finnish forest sector

The aim of this report is to give a comprehensive overview of the opportunities integrated biorefining can offer to Finnish forest industry companies and to assess what changes it would require from these companies to implement biorefining into their business. Also the strengths and weaknesses of the Finnish forest industry companies connected to biorefining are examined through innovation management theory frames, industry comparisons, company examples and couple of case-examples. The conclusions of the report include the statement that the Finnish forest industry has a good starting point for biorefinering and many advantages compared to other countries and industries. Unfortunately the history of the industry is holding it back and the thinking patterns would have to be altered to a more innovative and co-operational direction.

Developing the measurement and management of knowledge: applying the constructive research approach in a knowledge intensive service environment

Intellectual assets have attained continuous attention in the academic field, as they are vital sources of competitive advantage and organizational performance in the contemporary knowledge intensive business environment. Intellectual capital measurement is quite thoroughly addressed in the accounting literature. However, the purpose of the measurement is to support the management of intellectual assets, but the reciprocal relationship between measurement and management has not been comprehensively considered in the literature. The theoretical motivation for this study rose from this paradox, as in order to maximise the effectiveness of knowledge management the two initiatives need to be closely integrated. The research approach of this interventionist case study is constructive. The objective is to develop the case organization’s knowledge management and intellectual capital measurement in a way that they would be closely integrated and the measurement would support the management of intellectual assets. The case analysis provides valuable practical considerations about the integration and related issues as the case company is a knowledge intensive organization in which the know-how of the employees is the central competitive asset and therefore, the management and measurement of knowledge are essential for its future success. The results suggest that the case organization is confronting challenges in managing knowledge. In order to appropriately manage knowledge processes and control the related risks, support from intellectual capital measurement is required. However, challenges in measuring intellectual capital, especially knowledge, could be recognized in the organization. By reflecting the knowledge management situation and the constructed strategy map, a new intellectual measurement system was developed for the case organization. The construction of the system as well as its indicators can be perceived to contribute to the literature, emphasizing of the importance of properly considering the organization’s knowledge situation in developing an intellectual capital measurement system.

Management of stab wounds to the anterior abdominal wall

The meeting of the Publication "Evidence Based Telemedicine - Trauma and Emergency Surgery" (TBE-CiTE), through literature review, selected three recent articles on the treatment of victims stab wounds to the abdominal wall. The first study looked at the role of computed tomography (CT) in the treatment of patients with stab wounds to the abdominal wall. The second examined the use of laparoscopy over serial physical examinations to evaluate patients in need of laparotomy. The third did a review of surgical exploration of the abdominal wound, use of diagnostic peritoneal lavage and CT for the early identification of significant lesions and the best time for intervention. There was consensus to laparotomy in the presence of hemodynamic instability or signs of peritonitis, or evisceration. The wound should be explored under local anesthesia and if there is no injury to the aponeurosis the patient can be discharged. In the presence of penetration into the abdominal cavity, serial abdominal examinations are safe without CT. Laparoscopy is well indicated when there is doubt about any intracavitary lesion, in centers experienced in this method.