Työllistävät ympäristötyöt : Pohjois-Savon YTY -projektin toiminta vuonna 2009

Pohjois-Savon YTY on Euroopan sosaalirahaston, Työ- ja elinkeinoministeriön ja 17 pohjoissavolaisen kunnan rahoittama ympäristötyöprojekti. Projekti toteutetaan Manner-Suomen ESR-ohjelman Itä-Suomen suuralueosion toimintalinja 2:ssa, ”Työllistymisen ja työmarkkinoilla pysymisen edistäminen sekä syrjäytymisen ehkäiseminen”. Projektin tavoitteena on kouluttaa ja työllistää vuosittain 75 työtöntä ja/tai syrjäytymisuhan alla olevaa henkilöä ympäristön kunnostus- ja hoitotöihin. Koulutusjakson jälkeen työllistetyt siirtyvät työskentelemään kuntiin kuuden kuukauden ajaksi. Pohjois-Savon ympäristökeskukseen palkatut työnsuunnittelijat ohjaavat ja opastavat työllistettyjä työkauden aikana työkohteissa. Projektissa kiinnitetään erityistä huomiota työllistettyjen jatkotyöllistymismahdollisuuksien kartoittamiseen ja kouluttautumiseen. Projektiin liittyvä kuukauden mittainen koulutus toteutettiin samaan aikaan Iisalmessa, Juankoskella ja Suonenjoella. Koulutusten aikana suoritettiin tulityö-, työturvallisuus-, tieturva 1- ja ensiapu 1 -kortit. Koulutuksen jälkeen osallistujat siirtyivät työskentelemään kuntiin puolen vuoden ajaksi. Muutamissa kunnissa työntekijöiden työsuhteita jatkettiin vielä tämänkin jälkeen. Työjakson aikana toteutettiin monenlaisia ympäristön kunnostamiseen ja hoitamiseen liittyviä töitä. Työkohteet vaihtelivat yleisistä viheralueiden siistimis- ja hoitotöistä rakennusten kunnostamiseen ja uusien rakenteiden tekemiseen. Projektiin osallistui yhteensä 76 henkilöä. Työllistämisvaikutus oli 9042 henkilötyöpäivää. Julkaisussa esitetään yleiskatsaus projektin toimintaan vuonna 2009 ja esitellään kunnissa toteutettuja töitä.

Incidence of uterine post abortion infection at Hospital de Clínicas de Porto Alegre. Is prophylactic antibiotic necessary?

OBJECTIVE: To identify the incidence of pelvic infection after miscarriage undergoing uterine evacuation in a tertiary hospital in southern Brazil and to compare with the international literature.METHODS: we reviewed electronic medical records of the Hospital de Clinicas de Porto Alegre of all patients who underwent uterine evacuation for miscarriage between August 2008 and January 2012 were reviewed. We included all patients submitted to uterine curettage due to abortion and who had outpatient visits for review after the procedure. We calculated emographic and laboratory data of the study population, number needed for treatment (NNT) and number needed to harm (NNH).RESULTS: of the 857 revised electronic medical records, 377 patients were subjected to uterine evacuation for miscarriage; 55 cases were lost to follow-up, leaving 322 cases that were classified as not infected abortion on admission. The majority of the population was white (79%); HIV prevalence and positive VDRL was 0.3% and 2%, respectively. By following these 322 cases for a minimum of seven days, it was found that the incidence of post-procedure infection was 1.8% (95% CI 0.8 to 4). The NNT and NNH calculated for 42 months were 63 and 39, respectively.CONCLUSION: The incidence of post-abortion infection between August 2008 to January 2012 was 1.8% (0.8 to 4).

Searching for keys to successful post-merger integration : a longitudinal case-study following a public sector merger

Unsuccessful mergers are unfortunately the rule rather than the exception. Therefore it is necessary to gain an enhanced understanding of mergers and post-merger integrations (PMI) as well as learning more about how mergers and PMIs of information systems (IS) and people can be facilitated. Studies on PMI of IS are scarce and public sector mergers are even less studied. There is nothing however to indicate that public sector mergers are any more successful than those in the private sector. This thesis covers five studies carried out between 2008 and 2011 in two organizations in higher education that merged in January 2010. The most recent study was carried out two years after the new university was established. The longitudinal case-study focused on the administrators and their opinions of the IS, the work situation and the merger in general. These issues were investigated before, during and after the merger. Both surveys and interviews were used to collect data, to which were added documents that both describe and guide the merger process; in this way we aimed at a triangulation of findings. Administrators were chosen as the focus of the study since public organizations are highly dependent on this staff category, forming the backbone of the organization and whose performance is a key success factor for the organization. Reliable and effective IS are also critical for maintaining a functional and effective organization, and this makes administrators highly dependent on their organizations’ IS for the ability to carry out their duties as intended. The case-study has confirmed the administrators’ dependency on IS that work well. A merger is likely to lead to changes in the IS and the routines associated with the administrators’ work. Hence it was especially interesting to study how the administrators viewed the merger and its consequences for IS and the work situation. The overall research objective is to find key issues for successful mergers and PMIs. The first explorative study in 2008 showed that the administrators were confident of their skills and knowledge of IS and had no fear of having to learn new IS due to the merger. Most administrators had an academic background and were not anxious about whether IS training would be given or not. Before the merger the administrators were positive and enthusiastic towards the merger and also to the changes that they expected. The studies carried out before the merger showed that these administrators were very satisfied with the information provided about the merger. This information was disseminated through various channels and even negative information and postponed decisions were quickly distributed. The study conflicts with the theories that have found that resistance to change is inevitable in a merger. Shortly after the merger the (third) study showed disappointment with the fact that fewer changes than expected had been implemented even if the changes that actually were carried out sometimes led to a more problematic work situation. This was seen to be more prominent for routine changes than IS changes. Still the administrators showed a clear willingness to change and to share their knowledge with new colleagues. This knowledge sharing (also tacit) worked well in the merger and the PMI. The majority reported that the most common way to learn to use new ISs and to apply new routines was by asking help from colleagues. They also needed to take responsibility for their own training and development. Five months after the merger (the fourth study) the administrators had become worried about the changes in communication strategy that had been implemented in the new university. This was perceived as being more anonymous. Furthermore, it was harder to get to know what was happening and to contact the new decision makers. The administrators found that decisions, and the authority to make decisions, had been moved to a higher administrative level than they were accustomed to. A directive management style is recommended in mergers in order to achieve a quick transition without distracting from the core business. A merger process may be tiresome and require considerable effort from the participants. In addition, not everyone can make their voice heard during a merger and consensus is not possible in every question. It is important to find out what is best for the new organization instead of simply claiming that the tried and tested methods of doing things should be implemented. A major problem turned out to be the lack of management continuity during the merger process. Especially problematic was the situation in the IS-department with many substitute managers during the whole merger process (even after the merger was carried out). This meant that no one was in charge of IS-issues and the PMI of IS. Moreover, the top managers were appointed very late in the process; in some cases after the merger was carried out. This led to missed opportunities for building trust and management credibility was heavily affected. The administrators felt neglected and that their competences and knowledge no longer counted. This, together with a reduced and altered information flow, led to rumours and distrust. Before the merger the administrators were convinced that their achievements contributed value to their organizations and that they worked effectively. After the merger they were less sure of their value contribution and effectiveness even if these factors were not totally discounted. The fifth study in November 2011 found that the administrators were still satisfied with their IS as they had been throughout the whole study. Furthermore, they believed that the IS department had done a good job despite challenging circumstances. Both the former organizations lacked IS strategies, which badly affected the IS strategizing during the merger and the PMI. IS strategies deal with issues like system ownership; namely who should pay and who is responsible for maintenance and system development, for organizing system training for new IS, and for effectively run IS even during changing circumstances (e.g. more users). A proactive approach is recommended for IS strategizing to work. This is particularly true during a merger and PMI for handling issues about what ISs should be adopted and implemented in the new organization, issues of integration and reengineering of IS-related processes. In the new university an ITstrategy had still not been decided 26 months after the new university was established. The study shows the importance of the decisive management of IS in a merger requiring that IS issues are addressed in the merger process and that IS decisions are made early. Moreover, the new management needs to be appointed early in order to work actively with the IS-strategizing. It is also necessary to build trust and to plan and make decisions about integration of IS and people.

Long-term professional performance of minimally invasive surgery post-graduates

OBJECTIVE: to evaluate the contribution of a post-graduation program in surgeons professional careers. METHODS: participants were asked to answer a questionnaire with questions related to possible changes in their professional performance after the end of the course. RESULTS: forty-three (76.7%) of the 56 participants eligible for the study responded to the questionnaires. Most participants, 32 (74.4%), had previous contact with laparoscopic surgery; however, only 14 (32.5%) reported the experience as primary surgeon. The expectations on the course were reached or exceeded for 36 (83.7%) participants. Thirty-seven (86%) incorporated minimally invasive procedures in their daily surgical practice, 37 (86%) reported improvements in their income above 10% and 12% reported income increase of over 100%, directly related to their increase of laparoscopic activity. CONCLUSION: the program in minimally invasive surgery provides a high level of satisfaction to its participants, enables them to perform more complex technical procedures, such as sutures, and improves their professional economic performance.

Associated factors to empyema in post-traumatic hemotorax

ABSTRACTObjective:to analyze the associated factors with empyema in patients with post-traumatic retained hemothorax.Methods:prospective observational study. Data were collected in patients undergoing PD during emergency duty. Variables analyzed were age, sex, mechanism of injury, side of the chest injury, intrathoracic complications of RH, laparotomy, specific injuries, rib fractures, trauma scores, days to diagnosis, diagnostic method of RH, primary indication of PD, initial volume drained, length of the first tube removal, surgical procedure. Cumulative incidence of empyema, pneumonia and pulmonary contusion and the proportion of patients with empyema or without empyema in each category of each variable analyzed were obtained.Results: the cumulative incidence of PD among trauma patients was 1.83% and the RH among those with PD was 10.63%. There were 20 cases of empyema (32.8%). Most were male in the age from 20 to 29, victims of injury by firearm on the left side of the thorax. The incidence of empyema in patients with injury by firearms was lower compared to those with stab wound or blunt trauma; higher among those with drained volume between 300 and 599 ml. The median hospital lenght of stay was higher among those with empyema.Conclusion:the incidence of PD was 1.83% and RH was 10.63%, these results are consistent with the low severity of the patients involved in this study and consistent with the literature. The incidence of empyema proved to be negatively associated with the occurrence of injury by firearms and positively associated with a drained volume between 300 and 599 ml, compared with lower or higher volumes.

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Yleisten kirjastojen toiminta vuonna 2010 : Uusimaa, Itä-Uusimaa, Kanta-Häme, Päijät-Häme, Kymenlaakso, Etelä-Karjala

Uudenmaan ELY-keskuksen laajennettuun toimialueeseen kirjastoasioissa kuuluivat vuonna 2010 Uudenmaan, Itä-Uudenmaan, Kanta-Hämeen, Päijät-Hämeen, Kymenlaakson ja Etelä-Karjalan maakunnat. Alueen yleisten kirjastojen toimintaa vuonna 2010 esittelevässä tilastojulkaisussa ovat mukana kaikki 67 kirjastolaitosta. Julkaisun tiedot perustuvat ELY-keskuksen seuranta- ja arviointitietoihin alueen yleisten kirjastojen toiminnasta ja kehityksestä. Alueella oli 230 kirjastoa ja 39 kirjastoautoa. Vuoden 2010 alussa tapahtuneet kuntaliitokset vähensivät kirjastolaitosten määrää neljällä. Kokonaan lakkautettuja kirjastoja oli neljä, joista kaksi lähikirjastoa ja kaksi laitoskirjastoa. Kirjastojen aukioloajat kasvoivat vuodessa noin 1,4 %. Kirjastojen kokonaislainauksen ja fyysisten käyntien hidas lasku jatkui edelleen. Lainausten ja kävijöiden määrä asukasta kohden oli silti edelleen kansainvälistä huippua. Verkkokäyntien määrä oli hienoisessa nousussa. Kirjastojen kappalemääräinen aineistohankinta asukaslukuun suhteutettuna kasvoi hieman viime vuoteen verrattuna. Kirjastojen palkkaaman henkilöstön määrä asukaslukuun suhteutettuna pysyi edellisvuoden tasolla. Alueen kirjastojen toimintakulut kasvoivat 3,1 prosenttia vuodesta 2009. Uudenmaan ELY-keskus antoi lausunnot yleisten kirjastojen erityistehtävien valtionavustushakemuksista ja myönsi 49 kirjastolle avustusta kehittämistoimintaan. Ely-keskus tuki alueen kirjastohenkilöstön kansainvälisiin kokouksiin osallistumista ja järjesti yhteensä 13 koulutustilaisuutta kirjastohenkilöstölle.

Caracterização das lesões por Cysticercus bovis, na inspeção post mortem de bovinos, pelos exames macroscópico, histopatológico e pela reação em cadeia da polimerase (PCR)

Considerando a necessidade do conhecimento da cisticercose bovina e do aperfeiçoamento dos métodos de diagnóstico desta doença, objetivou-se verificar a ocorrência do Cysticercus bovis nos diversos locais anatômicos, tais como: cabeça, coração, esôfago, diafragma, língua, fígado e carcaça, examinados pelo Serviço de Inspeção Federal. O diagnóstico foi feito por macroscopia, microscopia e PCR com extração de DNA por fervura para a identificação do metacestóide. Dos 22043 bovinos abatidos, 713 (3,23%) estavam infectados. O coração foi o sítio anatômico mais afetado, com 1,90% (420/22043), seguido da cabeça, 1,11% (245/22043), do esôfago, 0,08% (18/22043), da carcaça, 0,07% (15/22043), do diafragma, 0,03% (7/22043), do fígado, 0,02% (5/22043) e da língua, 0,01% (3/22043). Dos cistos obtidos, 58,35% (416/713) estavam mortos e 41,65% (297/713), vivos. As diferenças entre os sítios anatômicos e a condição morfológica dos cistos foram significativas (p < 0,05). Dos 416 cistos mortos, 253 foram examinados por apresentarem características de: lesões nodulares firmes, brancacentas, com material amarelado, por vezes com aspecto calcário, no interior. O exame microscópico revelou granulomas comumente representados por centro necrótico e/ou mineralizado, envolto por histiócitos dispostos em paliçada, células gigantes multinucleadas, infiltrado misto, predominantemente de mononucleares, e fibrose. Por vezes, a periferia das lesões tinha características de tecido de granulação e mineralização em forma de lâminas lineares. Os restos parasitários foram identificados como um material hialino acelular, contendo elementos ovais e circulares, basofílicos, acidófilos e incolores, denominados corpúsculos calcários. Em algumas lesões foram observados raros corpúsculos, dispersos na reação inflamatória. Nódulos fibrosos, ricos em infiltrado linfóide ou crônico ativos, foram frequentemente visualizados. Dos cistos vivos examinados, 65% (13/20) foram positivos para C. bovis , confirmando o diagnóstico ambulatorial e a eficácia do método de PCR utilizado. Em virtude da positividade observada para C. bovis nos exames histopatológico e PCR, particularmente em fígado e esôfago, sugere-se que seja reformulado o artigo 176 do Regulamento de Inspeção Industrial e Sanitária de Produtos de Origem Animal, incluindo estes locais na rotina de inspeção nos matadouros.

Ammattimainen taloudellinen toiminta suomalaisessa huippujoukkueurheilussa

Tässä tutkimuksessa selvitetään suomalaisen koripallosarjan Korisliigan seurojen taloudellista toimintaa, nykytilaa ja kehitysmahdollisuuksia kohti ammattilaisuutta. Tutkimuksen teoriaosuudessa selvitetään yleisiä menestyvän urheiluliiketoiminnan peruspiirteitä. Seurojen tilinpäätöksistä tehdään kevyt tilinpäätösanalyysi ja lisäksi haastatellaan suomalaisen koripallon ja urheilun asiantuntijoita. Tutkimuksen tulokset osoittivat, että Korisliigan seurojen taloudellinen tilanne on hyvin epävakaa ja seurojen talous- ja strategiaosaaminen on heikkoa. Etenkin seurojen toiminnan suunnittelemattomuus ja lyhytjänteisyys nousivat esille tutkimuksessa. Tutkimuksen lopussa esitellään vielä mahdollisuuksia, miten Korisliigan toimintaa voitaisiin kehittää.

Uso de métodos complementares na inspeção post mortem de carcaças com suspeita de tuberculose bovina

O objetivo foi utilizar métodos complementares de diagnóstico (histopatológicos, bacteriológicos e moleculares), no julgamento de lesões suspeitas de tuberculose observadas durante a inspeção post mortem de rotina em abatedouros. Foi acompanhado o abate e a inspeção de 41.193 bovinos, sadios ao exame ante mortem, em sete abatedouros no estado de Mato Grosso. Carcaças de 198 (0,48%) animais apresentaram lesões, sendo 182 (92,0%) classificadas como granulomatosas ou piogranulomatosas na avaliação histopatológica. Entretanto, na baciloscopia, não foi evidenciada a presença de bacilo álcool-ácido resistente (BAAR). Mycobacterium bovis foi isolado em três (1,5%) lesões, provenientes de linfonodos retrofaringeanos de bovinos com até três anos de idade. Quando usado a PCR múltipla (m-PCR) diretamente nos fragmentos de tecido, detectou-se a presença de DNA de M. bovis em 14 (7,0%) lesões, incluindo as três amostras identificadas na análise bacteriológica. O julgamento das lesões pelo exame macroscópico concordou em 93,0% (184/198) com os resultados obtidos por meio da PCR. A fim de evitar equívocos durante a avaliação, principalmente das lesões paucibacilares, como as encontradas neste estudo, recomenda-se a utilização de testes complementares rápidos e confirmatórios. A m-PCR, associada à inspeção post mortem de rotina, demonstrou ser uma técnica promissora para a vigilância da tuberculose bovina em abatedouros, contribuindo para o sucesso do programa de erradicação da tuberculose bovina.