Hérnia intercostal transdiafragmática após fratura espontânea de costelas secundária à crise de tosse

One case of transdiafragmatic intercostal hernia after intense coughing fit followed by rib fractures in patient with history of pneumonia is presented. He had a severe coughing fit, developed a right toracoabdominal hematoma and then a tumor that was gradually enlarging. Image exams confirmed the diagnosis. Treatment consisted of surgical repair with the use of a polypropylene prosthetic mesh. It is a rare type of hernia. Only four cases were found in literature. The sooner the disease is diagnosed and treated the better the prognoses will be since it will prevent hernia from strangulation and incarceration.

Working capital management in the small and medium-sized enterprises Case: Project-based business environment in Flowrox Oy

This Master´s thesis illustrates how growing a business ties up the company´s working capital and what the cost of committed capital. In order to manage a company´s working capital in rapid business growth phase, the thesis suggests that by monitoring and managing the operating and cash conversion cycles of customers´ projects, a company can find ways to secure the required amount of capital. The research method of this thesis was based on literature reviews and case study research. The theoretical review presents the concepts of working capital and provides the background for understanding how to improve working capital management. The company in subject is a global small and medium-sized enterprise that manufactures pumps and valves for demanding process conditions. The company is expanding, which creates lots of challenges. This thesis concentrates to the company´s working capital management and its efficiency through the supply chain and value chain perspective. The main elements of working capital management are inventory management, accounts receivable management and accounts payable management. Prepayments also play a significant role, particularly in project-based businesses. Developing companies´ working capital management requires knowledge from different kind of key operations´ in the company, like purchasing, production, sales, logistics and financing. The perspective to develop and describe working capital management is an operational. After literature reviews the thesis present pilot projects that formed the basis of a model to monitor working capital in the case company. Based on analysis and pilot projects, the thesis introduces a rough model for monitoring capital commitments in short time period. With the model the company can more efficiently monitor and manage their customer projects.

The role of advance payments in working capital management and profitability

The objective of this thesis is to study the role of received advance payments in working capital management by creating a new measurement and to study the relationship between advance payments and profitability. The study has been conducted using narrative literature review and quantitative research methods. The research was made analyzing 108 companies listed in Helsinki Stock Exchange. The results indicate that 68 % of the studied companies are receiving advance payments and the average cycle time for received advance payments is 13 days. A new key figure is created to include received advance payments into the calculation of working capital. Received advance payments shorten the working capital cycle, by 13 days, when they are used in the calculation. The role of advance payments is not as significant as the role of receivables and inventories but advance payments may have a larger role than payables if the company is receiving noticeable amounts of advance payments. There are three branches where companies are receiving more advance payments than average companies. The branches are project business and ICT and publishing sectors. There is a negative correlation between profitability and advance payments based on the results of this study.

Recorrência da Crise Convulsiva após Terapia Anticonvulsivante com Sulfato de Magnésio em Pacientes com Eclâmpsia

Objetivos: determinar a freqüência de recorrência das crises convulsivas após tratamento com sulfato de magnésio, avaliando o tratamento adotado e o prognóstico materno. Casuística e Métodos: analisaram-se todos os casos de eclâmpsia atendidos no IMIP entre janeiro de 1995 e junho de 1998. Sulfato de magnésio e oxigenoterapia foram administrados para todas as pacientes, interrompendo-se a gravidez após estabilização do quadro clínico. Determinou-se a freqüência de complicações maternas de acordo com a presença ou não de recorrência da crise convulsiva, utilizando-se o teste chi² de associação, a um nível de significância de 5%. Resultados: doze pacientes apresentaram recorrência da eclâmpsia após sulfato de magnésio (10%), repetindo-se então metade da dose de ataque. Em 4 destas verificou-se nova recorrência, administrando-se então diazepam endovenoso. Depois do diazepam, uma paciente ainda teve crises repetidas, sendo então realizada infusão de fenitoína e, posteriormente, indução do coma barbitúrico (tionembutal). Essa paciente foi submetida a tomografia computadorizada, constatando-se hemorragia intracraniana. As complicações maternas foram significativamente mais freqüentes no grupo com recorrência: coma (16,7% versus 0,9%), acidose (50% versus 2,9%), edema agudo de pulmão (16,7% versus 2,9%), hemorragia cerebral (16,7% versus 0%) e insuficiência renal aguda (16,7% versus 1,9%). Ocorreram 3 casos de morte materna no grupo com recorrência (25%) e 2 no grupo sem recorrência (1,9%). Conclusões: a recorrência da crise convulsiva é pouco freqüente após uso do sulfato de magnésio (10%), porém associa-se a aumento da morbimortalidade materna, requerendo acompanhamento em UTI e realização de tomografia para exclusão de hemorragia cerebral.

Transmissão vertical do HIV em Fortaleza: revelando a situação epidemiológica em uma capital do nordeste

OBJETIVO: analisar as condutas que visam a redução da transmissão vertical do HIV nas grávidas infectadas atendidas nas maternidades públicas de Fortaleza. MÉTODOS: estudo descritivo no qual os bancos de dados do SINASC, SINAN e LACEN foram cruzados, procurando-se identificar as grávidas infectadas pelo HIV, seguido de busca ativa das informações complementares em prontuários médicos nas maternidades públicas. RESULTADOS: foram identificadas 138 grávidas infectadas pelo HIV. Observou-se que 35,5% destas já conheciam o status sorológico antes da gravidez e 48,6% foram diagnosticadas durante a gravidez. Das 101 grávidas que se souberam infectadas antes ou durante a gravidez, apenas 47,5% utilizaram, de forma correta, todas as etapas da profilaxia, incluindo as condutas para o recém-nascido. Associação estatisticamente significante foi encontrada entre o conhecimento prévio da sorologia para o HIV e realização de todas as etapas adequadas de profilaxia (p<0,001). CONCLUSÕES: encontrou-se elevado número de mulheres que não tiveram acesso às diferentes estratégias para redução da transmissão vertical, especialmente entre aquelas que engravidaram sem conhecimento de seu status sorológico. Faz-se necessária a contínua sensibilização e capacitação de todos os profissionais de saúde envolvidos com a assistência às mulheres, em geral, e às grávidas em especial, tendo em vista a aplicação correta das condutas para a redução da transmissão vertical do HIV.

Turku Åbo the former Capital of Finland

kuv., 10 x 22 cm

Fatores de associados à anemia em gestantes da rede pública de saúde de uma capital do Nordeste do Brasil

OBJETIVO: Avaliar os fatores associados à anemia em gestantes atendidas pela rede pública de saúde de uma capital do Nordeste do Brasil.MÉTODOS: Estudo de caráter transversal, envolvendo amostra (n=428) obtida, considerando a prevalência de anemia em gestantes (50%), um intervalo de confiança (IC) de 95%, um erro de 5% e uma perda amostral de 20%, sendo elegíveis gestantes que residiam no município e que eram atendidas pela rede pública de saúde municipal, das quais foram coletados dados socioeconômicos, de estilo de vida, clínicos, de consumo de ferro dietético, antropométricos e medida de hemoglobina capilar. A anemia foi identificada por um nível de hemoglobina <11 g/dL e sua associação com os fatores de risco foi testada por meio de análise de regressão múltipla de Poisson, com os resultados expressos pela Razão de Prevalência (RP) e IC95%.RESULTADOS: A prevalência de anemia foi de 28,3%, sendo maior naquelas gestantes com mais membros no domicílio (RP=1,49; IC95% 1,01-2,22; p=0,046) e naquelas que viviam com insegurança alimentar (RP=1,43; IC95% 1,00-2,04; p=0,047).CONCLUSÃO: A prevalência de anemia nas gestantes atendidas pela rede pública de saúde do município é um problema moderado de saúde pública, tornando necessário o planejamento de medidas efetivas para o seu controle.

Building a creative city brand through an international mega-event : Case: Helsinki World Design Capital 2012

In order to grow, cities are increasingly competing for attention, jobs, investments, visitors, residents and significant events. Cities need to come up with creative solutions to keep up with the competition; they ought to become creative cities. Attracting talented and diverse inhabitants is a key factor in developing a creative city, which on is characterized by openness, tolerance, vibrancy and diversity. Along the need for renewed city images city brand building has become popular. Helsinki is the World Design Capital 2012 (WDC 2012) and this mega-event presents a meaningful opportunity for the city to broadcast itself globally. The purpose of this study is to evaluate how Helsinki brands itself as a creative city through an international mega-event. The sub-aims are to: 1) Map the factors behind the creative city and their relation to the city of Helsinki, 2) Describe the city branding process, 3) Evaluate the role of the Helsinki World Design Capital 2012 mega-event in Helsinki’s creative city brand building. First, the theory discusses the concept of the creative city that has gained growing attention during the past decade. Then, the city branding process is described and the benefits of hosting a mega-event are presented. Finally, co-branding a city and a mega-event in order to generate maximum benefit from the mega-event, is reviewed. This is a qualitative research for which data was collected through three face-to-face interviews, the World Design Capital 2012 bid, Helsinki’s economic development strategy, a consulting firm’s research report on the case city and web-pages. The research reveals that Helsinki has shown interest in the creative city discussion. The terminology around the concept is however approached carefully. Helsinki fits many of the creative city characteristics and recognizes its flaws for which improvement strategies have been planned. Bottlenecks keeping the city from promoting a more open mind were mainly revealed in its organizational structures. Helsinki has no official brand strategy; nonetheless pressure to develop one is present. The World Design Capital 2012 mega-event is seen as a meaningful stepping board to strengthen Helsinki’s identity and image, and start thinking about a city brand. The brand strategies of the mega-event support the values and virtues of the city itself, which enables benefits of co-branding introduces in the theory part. Helsinki has no official brand and doesn’t call itself a creative city, however this study shows signs of the city taking steps towards building a creative city brand with the help of the Helsinki World Design Capital 2012 mega-event.

Capital Structure and Firm Growth: R&D Intensive Companies

The purpose of this study is to examine and explain firm`s growth impact on capital structure decision-making in research and development intensive companies. Many studies claim that R&D has a pivotal impact on capital structure decisions, but corporate finance theories have often failed to explain these observed patterns. As sales growth is an important concept and objective for R&D firms, it is logical to assume that it plays a vital role in capital structure decisions. This study applies nomothetic research approach. The theoretical part employs a formal conceptual analysis in order to develop the propositions that are tested with empirical data. The empirical part consists of the analysis of three companies; the data is obtained from the annual reports over the period 2003 – 2008. The companies operate in IT- or ICT-industry and are publicly listed. The method for analyzing the case data is based on the financial indicators, which are obtained from the financials of the case companies. These economic indicators describe the capital structure and the financial decision-making of the firms. The method relates to the quantitative studies. Yet, this study extends the analysis beyond the indicators. Specifically, this study addresses the question of what is behind the economic indicators, therefore combining aspects of quantitative and qualitative analysis. The firms examined in this study seem to prefer internal finance during growth. However, external finance seems to be a catalyst for sales growth. Firms strongly prefer equity financing. In growth, the use of equity per capital either increases or stays in a constant level. Over the period 2003 – 2008, the firms were often associated to equity related transactions and short-term debt. Short-term debt was used as a substitute of long-term debt and equity. The case firms also adjusted their capital structure – these adjustments were carried out with short-term debt or equity. The case data also provides implications for the growth signal theory that was developed in this study. Based on the econometric indicators, arguments can be made that equity investors are `attracted` to growing R&D firms. This is because growth helps investors perceive the true type of firm. The findings of this study are best explained by the trade-off theory and the pecking order theory. These corporate finance theories are considered as mainstream. Little support can be found to the implications of the signaling theory and market timing theory.