Very preterm infants in Finland - Use of health care services and economic consequences during the first five years of life

The aim of this thesis was to study the health, the hospitalisations, and the use of communal health care services in very preterm children during the first five years of life. In addition, the effect of very preterm birth and prematurity-related morbidities on the costs of hospitalisations, other health care services and the cost per quality adjusted life years (QALY) were studied. This population-based study included all very preterm children (gestational age (GA) <32 weeks or birth weight<1501g, N=2 064) and full-term controls (GA 37+0−41+6, N=200 609) born in Finland during 2000-2003. The data sources included national register data, costing data from the participating hospitals and parental questionnaires. This study showed that most very preterm infants born in Finland survived without prematurity-related morbidities diagnosed during the first years of life. They required relatively little hospital care after the initial discharge, which accounted for the vast majority of the total four-year hospitalisation costs. However, a minority of children born very preterm later developing morbidities had a long initial length of stay and more re-admissions and outpatient visits during the five-year follow-up period. In particular, the number and costs of non-emergency outpatient visits were considerable in individuals with prematurity-related morbidities. The need and costs of hospitalisations decreased clearly with each follow-up year, even in individuals with morbidities. The health-care related costs during the fifth year of life in children born very preterm without prematurity-related morbidities were close to the costs in infants born healthy at term. The cost per QALY of 19,245 € was at an acceptable level already by four years of age in the very preterm population as a whole. Prematurity-related later morbidities and decreasing GA increased the costs per QALY. As the initial hospital stay accounted for a great majority of the total four-year costs, and the costs of hospitalisation decreased with each follow-up year, the cost per QALY is likely to decrease with age. In conclusion, the majority of costs arising after the initial hospitalisation were associated with morbidities related to prematurity. Therefore offering high-quality neonatal care to prevent later morbidities in very preterm survivors has a long-term impact on the cost per QALY. In addition, this study indicates that when estimating the costs of prematurity after the first year of life, one should calculate not only the hospitalisation costs, but also other costs for social welfare services, primary care, and therapies, as these exceed the hospitalisation costs in very preterm infants during the fifth year of life.

Utilization of a Time Domain Simulator in the Technical and Economic Analysis of a Wind Turbine Electric Drive Train

The amount of installed wind power has been growing exponentially during the past ten years. As wind turbines have become a significant source of electrical energy, the interactions between the turbines and the electric power network need to be studied more thoroughly than before. Especially, the behavior of the turbines in fault situations is of prime importance; simply disconnecting all wind turbines from the network during a voltage drop is no longer acceptable, since this would contribute to a total network collapse. These requirements have been a contributor to the increased role of simulations in the study and design of the electric drive train of a wind turbine. When planning a wind power investment, the selection of the site and the turbine are crucial for the economic feasibility of the installation. Economic feasibility, on the other hand, is the factor that determines whether or not investment in wind power will continue, contributing to green electricity production and reduction of emissions. In the selection of the installation site and the turbine (siting and site matching), the properties of the electric drive train of the planned turbine have so far been generally not been taken into account. Additionally, although the loss minimization of some of the individual components of the drive train has been studied, the drive train as a whole has received less attention. Furthermore, as a wind turbine will typically operate at a power level lower than the nominal most of the time, efficiency analysis in the nominal operating point is not sufficient. This doctoral dissertation attempts to combine the two aforementioned areas of interest by studying the applicability of time domain simulations in the analysis of the economicfeasibility of a wind turbine. The utilization of a general-purpose time domain simulator, otherwise applied to the study of network interactions and control systems, in the economic analysis of the wind energy conversion system is studied. The main benefits of the simulation-based method over traditional methods based on analytic calculation of losses include the ability to reuse and recombine existing models, the ability to analyze interactions between the components and subsystems in the electric drive train (something which is impossible when considering different subsystems as independent blocks, as is commonly done in theanalytical calculation of efficiencies), the ability to analyze in a rather straightforward manner the effect of selections other than physical components, for example control algorithms, and the ability to verify assumptions of the effects of a particular design change on the efficiency of the whole system. Based on the work, it can be concluded that differences between two configurations can be seen in the economic performance with only minor modifications to the simulation models used in the network interaction and control method study. This eliminates the need ofdeveloping analytic expressions for losses and enables the study of the system as a whole instead of modeling it as series connection of independent blocks with no lossinterdependencies. Three example cases (site matching, component selection, control principle selection) are provided to illustrate the usage of the approach and analyze its performance.

The fear of openness : an essay on friendship and the roots of morality

Det förefaller självklart att begrepp som lojalitet, respekt, rättigheter eller altruism beskriver något entydigt gott. Men tänk om det i själva verket är så att de aktualiseras bara där vi avvisat godheten? Tänk om vår moral och hela vårt liv genomsyras av en djup förvirring, av en ovilja att se vad som egentligen pågår mellan oss? I min avhandling ställer jag de här obekväma frågorna. Utgångspunkten är en diskussion om vänskap, som jag beskriver som en förbehållslös, helhjärtad öppenhet mellan människor. Denna öppenhet – som lika väl kan kallas godhet eller kärlek – är det svåraste som finns. Samtidigt finns öppenheten alltid där mellan oss, om så bara som en anad möjlighet som skrämmer oss, som vi sluter oss för och inte vill veta av. Vi lever i en ständig spänning mellan öppenhet och avvisande, och denna spänning yttrar sig i allt vi gör, känner och tänker. Det är vad jag vill visa. Bland de filosofer jag diskuterar kan nämnas Aristoteles, Kant, Kierkegaard, Nietzsche och Emmanuel Levinas.

Convergence and divergence in global economy and social development : global perspectives on the contents of economic and soical development policy and its effects on rich and poor countries

The study of convergence and divergence in global economy and social development utilises comparative indicators to investigate the contents of economic and social development policy and their effects on the global samples that represent the rich industrial, semi-industrial and the poor developing nations. The study searchesfor answers to questions such as "what are the objectives of economic growth policies in globalisation under the imperatives of convergence and divergence, and how do these affect human well-being in consideration to the objectives of social policy in various nations?" The empirical verification of data utilises the concepts of the `logic of industrialism´ for comparative analysis that focuses mainly on identifying the levels of well-being in world nations after the Second World War. The perspectives of convergence and divergence in global economy and social development critically examine the stages of early development processes in global economy, distinguish the differences between economy and social development, illustrate the contents of economic and social development policies, their effects on rich and poor countries, and the nature of convergence and divergence in propelling economic growth and unequal social development in world nations. The measurement of convergence and divergence in global economy and social development utilised both economic and social data that were combined into an index that measures the precise levels of the effects of economic and social development policies on human well-being in the rich and poor nations. The task of finding policy solutions to resolve the controversies are reviewed through empirical investigations and the analyses of trends indicated within economic and social indicators and data. These revealed how the adoption of social policy measures in translating the gains from economic growth, towards promoting education, public health, and equity, generate social progress and longer life expectancy, higher economic growth, and sustain more stable macro economy for the nations. Social policy is concerned with the translation of benefits from objectives of global economic growth policies, to objectives of social development policy in nation states. Social policy, therefore, represents an open door whereby benefits of economic growth policies are linked with the broader objectives of social development policy, thereby enhancing the possibility of extending benefits from economic growth to all human being in every nation.

Canopy openness and lai estimates in two seasonally deciduous forests on limestone outcrops in central Brazil using hemispherical photographs

Patches of seasonally dry tropical forests occur on limestone outcrops in Central Brazil surrounded by the dominant savanna vegetation. They contain valuable timber species but are threatened by farming and mining activities. The objective of this study was to describe canopy opening and light relations in two seasonally deciduous dry forests on slopes and limestone outcrops, in the Paranã valley at the northeastern region of the Goiás state, Brazil. The studied forests were in the Fazenda Sabonete in Iaciara-Go and Fazenda Forquilha in Guarani-GO. Woody plants were sampled in 25 (20 x 20 m) plots in each forest. In the Sabonete forest 40 species, 705 ind./ha-1 with a basal area of 15.78 m²/ha-1 were found, while in Forquilha there were 55 species, 956 ind./ha-1 with a basal area of 24.76 m²/ha-1. Using hemispherical photographic techniques, 25 black and white photographs were taken at each site, during the dry season, totaling 50 photographs. These were taken at the beginning of each vegetation-sampling plot. The photographs were scanned in grey tones and saved as 'Bitmap'. The canopy opening and leaf area index (LAI) were calculated using the software Winphot. The mean canopy opening was 54.0% (±9.36) for Fazenda Sabonete and 64.6% (±11.8) in Fazenda Forquilha, with both sites presenting significant differences in the opening estimates (P < 0.05). Their floristic richness and structure also differed with the more open canopy forest, Forquilha, being richer and denser, suggesting the need for further studies on species-environment relationships in these forests.

Economic Geographical Analysis of The Finnish Paper Industry

The purpose of this academic economic geographical dissertation is to study and describe how competitiveness in the Finnish paper industry has developed during 2001–2008. During these years, the Finnish paper industry has faced economically challenging times. This dissertation attempts to fill the existing gap between theoretical and empirical discussions concerning economic geographical issues in the paper industry. The main research questions are: How have the supply chain costs and margins developed during 2001–2008? How do sales prices, transportation, and fixed and variable costs correlate with gross margins in a spatial context? The research object for this case study is a typical large Finnish paper mill that exports over 90 % of its production. The economic longitudinal research data were obtained from the case mill’s controlled economic system and, correlation (R2) analysis was used as the main research method. The time series data cover monthly economic and manufacturing observations from the mill from 2001 to 2008. The study reveals the development of prices, costs and transportation in the case mill, and it shows how economic variables correlate with the paper mills’ gross margins in various markets in Europe. The research methods of economic geography offer perspectives that pay attention to the spatial (market) heterogeneity. This type of research has been quite scarce in the research tradition of Finnish economic geography and supply chain management. This case study gives new insight into the research tradition of Finnish economic geography and supply chain management and its applications. As a concrete empirical result, this dissertation states that the competitive advantages of the Finnish paper industry were significantly weakened during 2001–2008 by low paper prices, costly manufacturing and expensive transportation. Statistical analysis expose that, in several important markets, transport costs lower gross margins as much as decreasing paper prices, which was a new finding. Paper companies should continuously pay attention to lowering manufacturing and transporting costs to achieve more profitable economic performance. The location of a mill being far from markets clearly has an economic impact on paper manufacturing, as paper demand is decreasing and oversupply is pressuring paper prices down. Therefore, market and economic forecasting in the paper industry is advantageous at the country and product levels while simultaneously taking into account the economic geographically specific dimensions.

Economic viability of retrofiting emitters in center pivot irrigation systems

Although several studies have been conducted to evaluate the uniformity of water application under center pivot irrigation systems, there are few studies concerning the economic perspective of such coefficient. The aim of this study is to present a methodology to accomplish an economic analysis as support for the decision-making to retrofit emitters in center pivot irrigation systems, and to attribute an economic meaning to the uniformity coefficient of water application taking into account the response function productivity to the amount of water applied and the sale price of the crops. In the hypothetic calculation example considering the variation of revenue of potato crop under center pivot irrigation system, it was verified that the area with uniformity coefficient of water application of 90% brought an income increase of BR$ 1,992.00, considering an area about 1,0 ha. Thus, it can be concluded that the methodology presented has met the objectives proposed in the study and made it possible to attribute an economical meaning to the coefficient of water uniformity application.

Technical and economic analysis of replacing artificial lighting system to induction of photoperiod effect in begonia's seedlings in greenhouse

The type of artificial light used for inducing photoperiod effect in begonia's seedlings at greenhouse has fundamental importance in the growth and development of these plants and directly reflects in the electrical energy consumption used in this production process. The objective of this research was to analyze the technical and economic feasibility of replacing the current technology of artificial lighting used by the producers (incandescent lamps), by the technology of discharge lamps with the purpose of inducing photoperiod in a greenhouse. The analysis results indicate that the discharge lamp of 32 W Tubular Fluorescent discharge lamp was the one that presented the lower peak demand and lower average energy consumption of 85.01% compared to incandescent filament lamp of 100 W that is the technology of bigger consumption and currently used by the producer.

Economic optimization method to design telescope irrigation of multiples outlets

In this study is presented an economic optimization method to design telescope irrigation laterals (multidiameter) with regular spaced outlets. The proposed analytical hydraulic solution was validated by means of a pipeline composed of three different diameters. The minimum acquisition cost of the telescope pipeline was determined by an ideal arrangement of lengths and respective diameters for each one of the three segments. The mathematical optimization method based on the Lagrange multipliers provides a strategy for finding the maximum or minimum of a function subject to certain constraints. In this case, the objective function describes the acquisition cost of pipes, and the constraints are determined from hydraulic parameters as length of irrigation laterals and total head loss permitted. The developed analytical solution provides the ideal combination of each pipe segment length and respective diameter, resulting in a decreased of the acquisition cost.

Technical and economic analysis of irrigation of asparagus bean in protected environment

This experiment was conducted in Lavras - state of Minas Gerais (MG), Brazil, in a protected environment, and aims to estimate the irrigation depths that maximize productivity and economic returns in the cultivation of asparagus bean and analyze the economic viability of irrigation management. The experimental delineation was randomized blocks with five treatments and four replications. The treatments consisted of five drip irrigation depths: 40, 70, 100, 130 and 160% of water replacement depth up to field capacity. The depths of water that maximize productivity and economic returns were obtained from the regression model adjusted to productivity data, cost of product relations and water cost. The economic viability was achieved on the benefit/cost ratio basis. The depth with the maximum economic return was estimated in 434.4mm, with a productivity of 35,160.6kg ha-1, which is economically viable for the cultivation of asparagus bean, with a expected profitability of R$ 1.70 for every real invested.