Risk factors for mortality in blunt abdominal trauma with surgical approach

ABSTRACTObjective:identify risk factors for mortality in patients who underwent laparotomy after blunt abdominal trauma.Methods:retrospective study, case-control, which were reviewed medical records of blunt trauma victims patients undergoing laparotomy, from March 2013 to January 2015, and compared the result of the deaths group with the group healed.Results:of 86 patients, 63% were healed, 36% died, and one patient was excluded from the study. Both groups had similar epidemiology and trauma mechanism, predominantly young adults males, automobilistic accident. Most cases that evolved to death had hemodynamic instability as laparotomy indication - 61% against 38% in the other group (p=0.02). The presence of solid organ injury was larger in the group of deaths - 80% versus 48% (p=0.001) and 61% of them had other associated abdominal injury compared to 25% in the other group (p=0.01). Of the patients who died 96% had other serious injuries associated (p=0.0003). Patients requiring damage control surgery had a higher mortality rate (p=0.0099). Only one of 18 patients with isolated hollow organ lesion evolved to death (p=0.0001). The mean injury score of TRISS of cured (91.70%) was significantly higher than that of deaths (46.3%) (p=0.002).Conclusion:the risk factors for mortality were hemodynamic instability as an indication for laparotomy, presence of solid organ injury, multiple intra-abdominal injuries, need for damage control surgery, serious injury association and low index of trauma score.

Analysis of value drivers behind CRM adoption projects in financial services industry

This research is focused on deriving framework for the value thought for from the Customer Relationship Management system adopted by an enterprise operating in the financial services industry. It will analyze existing academic work to derive a conceptual value model, while applying secondary industry specific case studies provided by the CRM vendors to check the validity and commonality of these drivers. Furthermore this work locates the variances and correlation between value thought for from CRM system, scope of enterprise operations and size of the enterprise.

Pipework data in design system integration

This thesis work describes the creation of a pipework data structure for design system integration. Work is completed in pulp and paper plant delivery company with global engineering network operations in mind. User case of process design to 3D pipework design is introduced with influence of subcontracting engineering offices. Company data element list is gathered by using key person interviews and results are processed into a pipework data element list. Inter-company co-operation is completed in standardization association and common standard for pipework data elements is found. As result inter-company created pipework data element list is introduced. Further list usage, development and relations to design software vendors are evaluated.

Yritysjärjestelyn toteutuneeseen kauppahintaan vaikuttavat tekijät – empiirinen tutkimus ulkoisen neuvonantajan suoriutumisesta yritysjärjestelyissä

Tämän Pro Gradu -tutkielman tavoitteena on tutkia mitkä tekijät vaikuttavat yritysjärjestelyn toteutuneeseen kauppahintaan. Lisäksi tämä tutkimus pyrkii vastaamaan mikä on ulkoisen neuvonantajan rooli kauppahinnan muodostumisessa sekä miten ulkoinen neuvonantaja suoriutuu erilaisista yritysjärjestelyistä. Tutkimuksen syntyä motivoi vähäinen tutkimusten määrä pienten yritysten yritysjärjestelyistä; yritysjärjestelyt toteutetaan usein puutteellisilla resursseilla ja epäonnistuneet yritysjärjestelyt nähdään uhkana Euroopan unionin talouskasvulle. Empiirinen tutkimus koostuu 104 toteutuneesta pienen yrityksen yritysjärjestelyn tilastollisesta analyysistä. Pääsääntöisesti otosta on tutkittu keskiarvovertailulla (Ttesti ja Oneway Anova) sekä korrelaatiotestauksella. Tutkimuksen tulokset osoittavat, että arvonmääritys on merkittävimmin kauppahintaan vaikuttava tekijä. Tämän lisäksi tilinpäätöstiedoilla on positiivinen yhteys kauppahintaan, kun taas myyntiajalla tai preemiolla ei ole yhteyttä kauppahintaan. Sekä osake- ja liiketoimintakaupan että sukupolvenvaihdosten ja yrityskauppojen välillä tehty keskiarvovertailu osoittaa, että ulkoinen neuvonantaja suoriutuu ammattitaitoisesti erilaisista yritysjärjestelytilanteista osaten huomioida näihin liittyviä erityispiirteitä.

Perspectives for using light quality knowledge as an advanced ecophysiological weed management tool

The current knowledge of light quality effects on plant morphogenesis and development represents a new era of understanding on how plant communities perceive and adjust to available resources. The most important consequences of light quality cues, often mediated by decreasing in red far-red ratios with respect to the spectral composition of incident sunlight radiation, affecting weed-crop interaction are the increased plant height and shoot to root ratio in anticipation of competition by light quantity, water or nutrients. Although the concepts related to light quality have been extensively studied and several basic process of this phenomenon are well known, little applications of photomorphogenic signaling currently are related to agricultural problems or weed management. The objectives of this review are to describe how light quality change can be a triggering factor of interspecific interference responses, to analyze how this phenomenon can be used to predict weed interference, to reevaluate the critical periods of interference concept, and to discuss its potential contribution towards developing more weed competitive crop varieties. Knowledge on light quality responses involved in plant sensing of interspecific competition could be used to identify red/far-red threshold values, indicating when weed control should be started. Light quality alterations by weeds can affect grain crop development mainly in high yielding fields. Unlike the traditional concept or the critical period of competition, light quality mediated interference implies that the critical period for weed control could start before the effects of direct resource (water, nutrients and available light) limitation actually occur. The variability in light quality responses among crop genotypes and the identification of mutants insensitive to light quality effects indicate that this characteristic can be selected or modified to develop cultivars with enhanced interspecific interference ability. Knowledge on light quality-elicited responses represents a new possibility to understand the underlying biology of interspecific interference, and could be used in the development of new weed management technologies.

Renal dysfunction in patients with sickle cell anemia or sickle cell trait

Patients with sickle cell anemia (Hb SS) or sickle cell trait (Hb AS) may present several types of renal dysfunction; however, comparison of the prevalence of these abnormalities between these two groups and correlation with the duration of disease in a large number of patients have not been thoroughly investigated. In a cross-sectional study using immunoenzymometric assays to measure tubular proteinuria, microalbuminuria, measurement of creatinine clearance, urinary osmolality and analysis of urine sediment, we evaluated glomerular and tubular renal function in 106 adults and children with Hb SS (N = 66) or Hb AS (N = 40) with no renal failure (glomerular filtration rate (GFR) >85 ml/min). The percentage of individuals with microalbuminuria was higher among Hb SS than among Hb AS patients (30 vs 8%, P<0.0001). The prevalence of microhematuria was similar in both groups (26 vs 30%, respectively). Increased urinary levels of retinol-binding protein or ß2-microglobulin were detected in only 3 Hb SS and 2 Hb AS patients. Urinary osmolality was reduced in patients with Hb SS or with Hb AS; however, it was particularly evident in Hb SS patients older than 15 years (median = 393 mOsm/kg, range = 366-469) compared with Hb AS patients (median = 541 mOsm/kg, range = 406-722). Thus, in addition to the frequently reported early reduction of urinary osmolality and increased GFR, nondysmorphic hematuria was found in 26 and 30% of patients with Hb SS or Hb AS, respectively. Microalbuminuria is an important marker of glomerular injury in patients with Hb SS and may also be demonstrated in some Hb AS individuals. Significant proximal tubular dysfunction is not a common feature in Hb SS and Hb AS population at this stage of the disease (i.e., GFR >85 ml/min).

Omistuksen tavoitteellisuus perheyrityksissä - kartoitus omistamisen tavoitteista ja tavoitteiden määrittelystä

Suomi tarvitsee menestyviä yrittäjiä, uusia yrityksiä, kasvuyrityksiä ja kansainvälistymistä. Yrittä-jyydelle asetetaankin suuria odotuksia. Suurin huomio yrittäjyyden tarkastelussa on kuitenkin keskittynyt liiketoimintojen kehittämiseen – sen sijaan omistajuuden ja yrittäjyyden yhteyttä ei ole juurikaan huomioitu. Tämän seurauksena myös omistajuuden vaikutusta yrityksen kehittymi-seen ja menestykseen on analysoitu vähän. Edistääkseen yrityksen kehittymistä, tulee omistuksen olla tavoitteellista. Omistamisen tavoittei-den tarkastelu on kuitenkin harvinaista ja parhaimmillaankin yksiulotteista: omistamisen tavoit-teiden nähdään liittyvän lähes yksinomaan taloudellisiin tavoitteisiin, ja tavoitteiden moninaisuus unohdetaan. Tässä tutkimuksessa tarkastellaan suomalaisten perheyrittäjien omistamisen tavoit-teellisuutta, tavoitteiden määrittelyä sekä omistajaohjauksen keinoja, lähinnä hallituksen roolia, omistukseen liittyvien ratkaisujen tekijänä. Tutkimushankkeen aineisto kerättiin EK:n ja Perheyritysten liiton jäsenyrityksistä. Aineisto kerät-tiin joulukuussa 2013 ja tammikuussa 2014 web-pohjaisella kyselyllä ja siihen vastasi määräajan kuluessa 332 vastaajaa. Vastaajista perheyrityksiä oli 241 kpl. Tarkemman analyysin kohteeksi jäi 233 perheyritystä. Tutkimuksen tulokset osoittavat, että suomalaisten yrittäjien omistajuuteen liittyvät tavoitteet ovat monipuolisempia kuin yleisesti oletetaan. Puhtaasti taloudellisiin motiiveihin perustuvan yri-tysten omistamisen ohella liiketoimintaan kohdistuva mielenkiinto ja halu toimia yrittäjänä ovat merkittäviä omistamisen vaikuttimia. Suuri joukko yritysten omistajista ei kuitenkaan tietoisesti pohdi omistamisen tavoitteita vaan omistuksen tavoitteet määrittyvät liiketoiminnan tavoitteiden tai totuttujen tapojen ja perinteiden kautta. Osalla yritysten omistajista omistus muuttuu tavoit-teellisemmaksi yrityksen kehittyessä ja omistajajoukon kasvaessa. Ensimmäisen sukupolven yrittäjät näyttävät toimivan ennen kaikkea yrittäjäideologian mukaisesti pyrkien kasvattamaan yritystä ja painottaen liiketaloudellisia arvoja päätöksenteossa. Yritystoi-minnan kehittyessä ja sukupolvien lisääntyessä yrityksen omistamiseen liittyvät tavoitteet moni-puolistuvat ja monimutkaistuvat, eivätkä enää perustu pelkästään liiketoiminnallisiin menes-tysodotuksiin. Hallitustoiminnan aktivointi aktivoi myös omistuksen tavoitteellisuuden kehittymistä. Omistus-pohjan hajaantuminen lisää tarvetta erilaisten omistajaohjauksen mekanismien hyödyntämiselle. Hallituksella näyttää olevan rooli omistusratkaisuiden arvioinnissa sekä yrityksen operatiiviseen toimintaan liittyvissä omistusratkaisuissa, mutta myös läheisemmin omistamiseen ja omistajapoh-jaan liittyvissä omistusratkaisuissa. Perheomistukseen liittyvien tavoitteiden huomioiminen on tärkeää perheyrityksen hallituksen toiminnassa myös yrityksen toiminnan vakiintuessa. Sen sijaan, että perheeseen liittyvät omista-misen tavoitteet katoaisivat yrityksestä, muuttuu niiden määrittely tietoisemmaksi ja osaksi yri-tyksen hallintoa. Määräysvallan merkitys tavoitteena pienenee, kun omistajan etäisyys operatiivi-sesta toiminnasta, tai sen johtamisesta kasvaa. Tutkimuksen tulokset kertovat omistamisen tavoitteista ja tavoitteiden määrittelystä. Selvityksen lopussa luotiin määritelmä päämäärätietoiselle omistajalle: Päämäärätietoinen omistaja on omista-ja, joka tietoisesti pohtii tavoitteita omistamiselleen sekä käyttää aktiivisesti omistajavaltaansa valitsemiensa päämäärien saavuttamiseksi.

Hoitokuluanalyysi Suomen yksityisen sektorin työeläkejärjestelmästä

Tämän pro gradu -tutkielman tavoitteena on tutkia Suomen työeläkevakuutusyhtiöiden työeläkevakuutusmaksun hoitokustannusosalla katettavia liikekuluja ja muodostaa analyysi Suomen työeläkevakuutusjärjestelmän liikekulujen kehittymisestä ja tehokkuuden tasosta. Tehokkuusnäkökulman lisäksi tarkastellaan työeläkejärjestelmän kilpailuolosuhteita. Tutkimusta motivoi työeläkealalle ajankohtainen asia, joka liittyy yhtiökohtaisen hinnoittelumallin mahdolliseen käyttöönottoon, jota parhaillaan suunnitellaan työeläkealan tehokkuuden ja kilpailullisuuden lisäämiseksi. Yhtiökohtaisessa hinnoittelumallissa työeläkeyhtiö voisi itsenäisesti vaikuttaa työeläkevakuutuksen hintaan hoitokustannusosan kautta, joka määräytyisi pitkälti sen mukaan kuinka tehokkaasti yhtiö pystyy toimintansa järjestämään. Empiirinen tutkimus on toteutettu kvalitatiivisena tapaustutkimuksena, jossa kuitenkin empiirinen analyysi perustuu kvantitatiiviseen aineistoon ja aineistoa on käsitelty kvantitatiivisen tutkimuksen menetelmin. Pääasiallisina tutkimusotteina on käytetty taulukointia ja erinäisten muuttujien välistä korrelaatiota. Tuloksien suhteen on käytetty aineistolähtöistä induktiivista päättelyä. Tutkimuksessa on tutkittu seitsemän yksityisen sektorin työeläkeyhtiön liikekuluja vuosilta 2006–2013. Tutkimustuloksien mukaan järjestelmätasolla tarkasteltuna työeläkeyhtiöiden toiminta on tehokasta, joskin yksittäisten yhtiöiden välillä on suuriakin tehokkuuseroja. Vakuutusten ja korvaustoiminnan hoito ovat suurimmat kustannusten aiheuttajat. Työeläkemarkkinat ovat hyvin keskittyneet ja muistuttavat enemmänkin oligopolisia markkinoita kuin täydellisen kilpailun markkinoita.

A morphometric study of the lumbar spinous process in the Chinese population

Our goal was to analyze the anatomical parameters of the lumbar spine spinous process for an interspinous stabilization device designed for the Chinese population and to offer an anatomical basis for its clinical application. The posterior lumbar spines (T12-S1) of 52 adult cadavers were used for measuring the following: distance between two adjacent spinous processes (DB), distance across two adjacent spinous processes (DA), thickness of the central spinous processes (TC), thickness of the superior margin of the spinous processes (TS), thickness of the inferior margin of the spinous processes (TI), and height of the spinous processes (H). Variance and correlation analyses were conducted for these data, and the data met the normal distribution and homogeneity of variance. DB decreased gradually from L1-2 to L5-S1. DA increased from T12-L1 to L2-3 and then decreased from L2-3 to L4-5. The largest H in males was noted at L3 (25.45±5.96 mm), whereas for females the largest H was noted at L4 (18.71±4.50 mm). Usually, TS of the adjacent spinous process was lower than TI. Based on the anatomical parameters of the lumbar spinous processes obtained in this study, an “H”-shaped coronal plane (posterior view) was proposed as an interspinous stabilization device for the Chinese population. This study reports morphometric data of the lumbar spinous processes in the Chinese population, which provides an anatomical basis for future clinical applications.

Analysis of testicular cell populations using flow cytometry

Studying testis is complex, because the tissue has a very heterogeneous cell composition and its structure changes dynamically during development. In reproductive field, the cell composition is traditionally studied by morphometric methods such as immunohistochemistry and immunofluorescence. These techniques provide accurate quantitative information about cell composition, cell-cell association and localization of the cells of interest. However, the sample preparation, processing, staining and data analysis are laborious and may take several working days. Flow cytometry protocols coupled with DNA stains have played an important role in providing quantitative information of testicular cells populations ex vivo and in vitro studies. Nevertheless, the addition of specific cells markers such as intracellular antibodies would allow the more specific identification of cells of crucial interest during spermatogenesis. For this study, adult rat Sprague-Dawley rats were used for optimization of the flow cytometry protocol. Specific steps within the protocol were optimized to obtain a singlecell suspension representative of the cell composition of the starting material. Fixation and permeabilization procedure were optimized to be compatible with DNA stains and fluorescent intracellular antibodies. Optimization was achieved by quantitative analysis of specific parameters such as recovery of meiotic cells, amount of debris and comparison of the proportions of the various cell populations with already published data. As a result, a new and fast flow cytometry method coupled with DNA stain and intracellular antigen detection was developed. This new technique is suitable for analysis of population behavior and specific cells during postnatal testis development and spermatogenesis in rodents. This rapid protocol recapitulated the known vimentin and γH2AX protein expression patterns during rodent testis ontogenesis. Moreover, the assay was applicable for phenotype characterization of SCRbKO and E2F1KO mouse models.

Effectiveness of instructional strategies based on schema theory on attention deficit disorder children

A review of the literature reveals that there are a number of children in the educational system who are characterized by Attention Deficit Disorder. Further review of the literature reveals that there are information processing programs which have had some success in increasing the learning of these children. Currently, an information processing program which is based on schema theory is being implemented in Lincoln County. Since schema theory based programs build structural, conditional, factual, and procedural schemata which assist the learner in attending to salient factors, learning should be increased. Thirty-four children were selected from a random sampling of Grade Seven classes in Lincoln County. Seventeen of these children were identified by the researcher and classroom teacher as being characterized by Attention Deficit Disorder. From the remaining population, 17 children who were not characterized by Attention Deficit Disorder were randomly selected. The data collected were compared using independent t-tests, paired t-tests, and correlation analysis. Significant differences were found in all cases. The Non-Attention Deficit Disorder children scored significantly higher on all the tests but the Attention Defici t Disorder children had a significantly higher ratio of gain between the pretests and posttests.

Modified statistical methods to calculate rare gas interaction potentials

New density functionals representing the exchange and correlation energies (per electron) are employed, based on the electron gas model, to calculate interaction potentials of noble gas systems X2 and XY, where X (and Y) are He,Ne,Ar and Kr, and of hydrogen atomrare gas systems H-X. The exchange energy density functional is that recommended by Handler and the correlation energy density functional is a rational function involving two parameters which were optimized to reproduce the correlation energy of He atom. Application of the two parameter function to other rare gas atoms shows that it is "universal"; i. e. ,accurate for the systems considered. The potentials obtained in this work compare well with recent experimental results and are a significant improvement over those from competing statistical modelS.

Exploring Chinese-Canadians' perspectives on health : a quantitative study

Chinese have unique perspectives on health and illness, which is mostly umecognized by western medicine. Immigration may contribute to problems with health consultations, inconvenience, and dissatisfaction. As the largest visible minority in Canada, Chinese- Canadians' perspectives on health should be studied in order to help Chinese immigrants adapt to a new health-care and health-promotion system, and keep them healthy. A quantitative questionnaire was designed based on the findings from a pilot study and previous literature. A hundred participants were recruited from Toronto, Vancouver, Halifax, and St. Catharines. Descriptive analysis and correlation analysis were used to investigate the structure of the variables. Findings indicated that most oftheir attitudes and corresponding practices to the different health aspects were positive. The relation between dietary practices and attitude was only found in small cities. Their attitudes were impacted by their length of stay in Canada. Their attitudes to regularly timed meals and psychological consultation were related to their acculturation level, as was the regularity of their practice of dental flossing. Their self-evaluated general health levels were also found to be affected by their medical history, education level, feeling to talk about • sexual health, and smoking, particularly in the male subjects of the study. In conclusion, they realized that each health aspect w~s important to their health. However, their practices did not bear a strong relation to their beliefs. Traditional thoughts about health reseeded with time. Acculturation level did not affect most of their attitudes or practices. Under pressure, the priority of the daily health practices decreased. Older persons, those with low incomes, lower education levels or families under stress need to pay more attention to their health level. In-depth future research was recommended.

Estelle Cuffe Hawley fonds, 1852-1999, n.d.

Estelle Cuffe Hawley (1894-1995) was an educator, businesswoman and politician, who became the first woman alderman on the St. Catharines City Council. She began her career as a teacher in Peterborough in 1913, and later taught in St. Catharines at Connaught School and St. Paul’s Ward School, where she served as Principal for six years. In 1928-29, she worked as an exchange teacher in Edmonton, Alberta. This would be Estelle’s last year in the teaching profession. She moved back to St. Catharines in 1930 and began a career in business, as an employee of Sun Life Assurance Co. She remained in this profession until around 1952. It was during this period that she became very active in the community and local politics. In 1934 she was elected to the St. Catharines Board of Education, where she advocated for the improvement of teachers’ salaries, the introduction of nursing services in schools, and the inclusion of music in the curriculum. She served as a member of the school board until 1937. The following year, she became the first woman elected to the St. Catharines City Council. As an alderman, she worked to improve the community's social welfare services, serving consecutively as chairman of all committees. She established comprehensive health services (including medical, dental and nursing), in the public, separate and secondary schools of St. Catharines, the first program of its kind in Canada. She was also instrumental in establishing minimum housing standards and engaging the public in local government by arranging a series of lectures by city officials. She remained a member of City Council until 1943. The following year she campaigned unsuccessfully for the mayoralty. In 1953 she married Hubert Hawley and moved to Orillia. She continued to remain active in the community, serving as President of the Ontario Recreation Association from 1950-1953, and editor of their Bulletin from 1955-1961. During the 1960s, she worked with various groups, including the Voice of Women, the Mental Health Association and the Freedom from Hunger Campaign. In addition to this work, Estelle wrote poetry and short stories, some of which were published in the Peterborough Review, the Globe and Mail and the Canadian Churchman. Some of her short stories (often about her childhood experiences) were broadcast on the CBC, as well as her experiences as a Town Councillor (under the pseudonym Rebecca Johnson in 1961). She also broadcast a segment that was part of a series called “Winning the Peace” in April 1944. Estelle was a sought-after public speaker, speaking on topics such as peace, democracy, citizenship, education, and women’s rights. In 1976, Brock University conferred an honorary Doctor of Law degree to Estelle for her leadership as an educator, businesswoman and a stateswoman. Her husband Hubert died that same year, and Estelle subsequently moved to Mississauga. With the assistance of an Ontario Heritage Foundation grant, she began work on her memoir. She later moved back to Orillia and died there in 1995, at the age of 101.

Roberta "Bobbie" Styran fonds, 1707-2013, n.d.

Roberta “Bobbie” Styran was born and rasied in Fredericton, N.B. She graduated from McMaster University with a B.A. (1962) and M.A. (1964), before furthering her studies at the University of Toronto, where she received a Ph. D in History. From 1967 to 1978, she taught Medieval History at Brock University, where she developed an interest in the Welland Canal. She began a collaboration with Prof. Robert R. Taylor of the History Department at this time, researching the history of the Welland Canals. She later moved to Toronto and worked for the Ministry of Education, but returned to St. Catharines in 1988 to facilitate her work with Prof. Taylor. The two have co-authored several books, including The Welland Canals: the Growth of Mr. Merritt’s Ditch; Mr. Merritt’s Ditch: A Welland Canals Album; The Great “Swivel Link”: Canada’s Welland Canal and This Great National Object: Building the Nineteenth-Century Welland Canals. Bobbie travelled extensively, visiting many canal and industrial revolution sites in Great Britain and the United States. She was active in many canal associations, including the Canadian Canal Society (where she served as president and editor of the Society’s newsletter), the American Canal Society, and the Council of Inland Waterways International. She also helped to found the Welland Canals Preservation Association and organized and chaired the 2004 World Canals Conference at Brock University. In 2009, she received the W. Gordon Plewes Award from the Canadian Society for Civil Engineering, an award that recognized her services to Canadian engineering history.