Radiographic volume analysis as a novel tool to determine nasopalatine duct cyst dimensions and its association with presenting symptoms and postoperative complications.

OBJECTIVES: The aims of the study were to use cone beam computed tomography (CBCT) images of nasopalatine duct cysts (NPDC) and to calculate the diameter, surface area, and 3D-volume using a custom-made software program. Furthermore, any associations of dimensions of NPDC with age, gender, presence/absence of maxillary incisors/canines (MI/MC), endodontic treatment of MI/MC, presenting symptoms, and postoperative complications were evaluated. MATERIAL AND METHODS: The study comprised 40 patients with a histopathologically confirmed NPDC. On preoperative CBCT scans, curves delineating the cystic borders were drawn in all planes and the widest diameter (in millimeter), surface area (in square millimeter), and volume (in cubic millimeter) were calculated. RESULTS: The overall mean cyst diameter was 15 mm (range 7-47 mm), the mean cyst surface area 566 mm(2) (84-4,516 mm(2)), and the mean cyst volume 1,735 mm(3) (65-25,350 mm(3)). For 22 randomly allocated cases, a second measurement resulted in a mean absolute aberration of ±4.2 % for the volume, ±2.8 % for the surface, and ±4.9 % for the diameter. A statistically significant association was found for the CBCT determined cyst measurements and the need for preoperative endodontic treatment to MI/MC and for postoperative complications. CONCLUSION: In the hands of a single experienced operator, the novel software exhibited high repeatability for measurements of cyst dimensions. Further studies are needed to assess the application of this tool for dimensional analysis of different jaw cysts and lesions including treatment planning. CLINICAL RELEVANCE: Accurate radiographic information of the bone volume lost (osteolysis) due to expansion of a cystic lesion in three dimensions could help in personalized treatment planning.

Diffusion of Administrative Innovation: TQM Implementation and Effectiveness in a Global

The main objective of this dissertation is to create new knowledge on an administrative innovation, its adoption, diffusion and finally its effectiveness. In this dissertation the administrative innovation is approached through a widely utilized management philosophy, namely the total quality management (TQM) strategy. TQM operationalizes a self-assessment procedure, which is based on continual improvement principles and measuring the improvements. This dissertation also captures the theme of change management as it analyzes the adoption and diffusion of the administrative innovation. It identifies innovation characteristics as well as organisational and individual factors explaining the adoption and implementation. As a special feature, this study also explores the effectiveness of the innovation based on objective data. For studying the administrative innovation (TQM model), a multinational Case Company provides a versatile ground for a deep, longitudinal analysis. The Case Company started the adoption systematically in the mid 1980s in some of its units. As part of their strategic planning today, the procedure is in use throughout the entire global company. The empirical story begins from the innovation adoption decision that was made in the Case Company over 22 years ago. In order to be able to capture the right atmosphere and backgrounds leading to the adoption decision, key informants from that time were interviewed, since the main target was to clarify the dynamics of how an administrative innovation develops. In addition, archival material was collected and studied, available memos and data relating to the innovation, innovation adoption and later to the implementation contained altogether 20500 pages of documents. A survey was furthermore conducted at the end of 2006 focusing on questions related to the innovation, organization and leadership characteristics and the response rate totalled up to 54%. For measuring the effectiveness of the innovation implementation, the needed longitudinal objective performance data was collected. This data included the profit unit level experience of TQM, the development of the self assessment scores per profit unit and performance data per profit unit measured with profitability, productivity and customer satisfaction. The data covered the years 1995-2006. As a result, the prerequisites for the successful adoption of an administrative innovation were defined, such as the top management involvement, support of the change agents and effective tools for implementation and measurement. The factors with the greatest effect on the depth of the implementation were the timing of the adoption and formalization. The results also indicated that the TQM model does have an effect on the company performance measured with profitability, productivity and customer satisfaction. Consequently this thesis contributes to the present literature (i) by taking into its scope an administrative innovation and focusing on the whole innovation implementation process, from the adoption, through diffusion until its consequences, (ii) because the studied factors with an effect on the innovation adoption and diffusion are multifaceted and grouped into individual, organizational and environmental factors, and a strong emphasis is put on the role of the individual change agents and (iii) by measuring the depth and consistency of the administrative innovation. This deep analysis was possible due to the availability of longitudinal data with triangulation possibilities.

Rakentaako Chen evaluaatiotutkimukselle sen tuolista puuttuvat kaksi jalkaa - vai vahvistaako hän jo olemassa olevaa? Entä selkänoja? Tarvitseeko evaluaatiotutkimus laajemmasta näkökulmasta oman irtotuolin sijasta penkin vai torin, jolla ei ole edes penkkejä?

Abstract:Does evaluation need a three-legged stool? Should there be even more legs in the stool for evaluation or should evaluation have a bench? Or would it be best or more practical for evaluation if it was a square or marketplace without any kind of stools or bench? What is Huey-Tsyh Chen doing for evaluation in his new "Practical evaluation"?

Planning and reporting of quality-of-life outcomes in cancer trials.

BACKGROUND: Information about the impact of cancer treatments on patients' quality of life (QoL) is of paramount importance to patients and treating oncologists. Cancer trials that do not specify QoL as an outcome or fail to report collected QoL data, omit crucial information for decision making. To estimate the magnitude of these problems, we investigated how frequently QoL outcomes were specified in protocols of cancer trials and subsequently reported. DESIGN: Retrospective cohort study of RCT protocols approved by six research ethics committees in Switzerland, Germany, and Canada between 2000 and 2003. We compared protocols to corresponding publications, which were identified through literature searches and investigator surveys. RESULTS: Of the 173 cancer trials, 90 (52%) specified QoL outcomes in their protocol, 2 (1%) as primary and 88 (51%) as secondary outcome. Of the 173 trials, 35 (20%) reported QoL outcomes in a corresponding publication (4 modified from the protocol), 18 (10%) were published but failed to report QoL outcomes in the primary or a secondary publication, and 37 (21%) were not published at all. Of the 83 (48%) trials that did not specify QoL outcomes in their protocol, none subsequently reported QoL outcomes. Failure to report pre-specified QoL outcomes was not associated with industry sponsorship (versus non-industry), sample size, and multicentre (versus single centre) status but possibly with trial discontinuation. CONCLUSIONS: About half of cancer trials specified QoL outcomes in their protocols. However, only 20% reported any QoL data in associated publications. Highly relevant information for decision making is often unavailable to patients, oncologists, and health policymakers.

Maakuntalaisten osallistuminen Kainuun halintokokeiluun suunnitteluvaiheessa

Abstract: Provincial involvement at the planning stage of the Kainuu administrative experiment

Analyse de la situation de la Consultation de santé sexuelle Planning familial de Profa

Le présent rapport est structuré de la manière suivante : le chapitre 2 décrit la méthode utilisée ; le chapitre 3 est consacré à l'activité de consultation et le chapitre 4 à l'action communautaire. Le chapitre 5 concerne la notion de centre de référence. Une analyse ciblée de la littérature, ainsi que les consultations de santé sexuelle dans les autres cantons romands sont présentés au chapitre 6. Les conclusions et recommandations sont exposées au chapitre 7.

Kustannusrakenteen simulointi ja optimointi

Primääripakatun tuotteen liiketoiminnallisen arvoketjun kustannusrakenteen tunnistaminen tuo merkittävää lisäarvoa pakkausliiketoiminnan suunnittelua koskevaan päätöksentekoon. Tämän konstruktiivisen tutkimuksen tavoitteena on rakentaa pakkaustuotannon liiketoiminnallisen arvoketjun simulointimalli, jonka avulla voidaan analysoida pakkaustuotannon arvoketjun kustannusrakennetta lähtien pakkausraaka-aineen valmistuksesta ja päättyen kaupan vähittäismyyntiin. Käytettävä tutkimusaineisto koostuu jonoteoriaan ja tuotannonsuunnitteluun liittyvästä kirjallisuudesta, tieteellisistä artikkeleista sekä asiantuntijalausunnoista. Tutkimuksen yhteydessä rakennetun simulointimallin avulla määritettiin erään primääripakatun tuotteen konvertointivaiheen optimaalinen valmistuseräkoko ja liiketoiminnallisen arvoketjun kustannusrakenne. Arvoketjuanalyysissä primääripakatun tuotteen kustannustekijöiksi määritettiin pakkausmateriaali, pakkausvalmistus, pakattava tuote, pakkauksen täyttö ja suljenta sekä pakatun tuotteen jakelulogistiikka ja vähittäismyynti. Arvoketjuanalyysin johtopäätöksenä voidaan todeta, että primääripakatulle esimerkkituotteelle kohdistuvista kustannuksista noin 97 % on brand ownerin ja vähittäismyynnin aiheuttamia ja noin 3 % varsinaisesta tuotteen pakkaamisesta aiheutuvia.

A Model for Product Transfer Project

In this thesis a model for managing the product data in a product transfer project was created for ABB Machines. This model was then applied for the ongoing product transfer project during its planning phase. Detailed information about the demands and challenges in product transfer projects was acquired by analyzing previous product transfer projects in participating organizations. This analysis and the ABB Gate Model were then used as a base for the creation of the model for managing the product data in a product transfer project. The created model shows the main tasks during each phase in the project, their sub-tasks and relatedness on general level. Furthermore the model emphasizes need for detailed analysis of the situation during the project planning phase. The created model for managing the product data in a product transfer project was applied into ongoing project two main areas; manufacturing instructions and production item data. The results showed that the greatest challenge considering the product transfer project in previously mentioned areas is the current state of the product data. Based on the findings, process and resource proposals for both the ongoing product transfer project and the BU Machines were given. For manufacturing instructions it is necessary to create detailed process instructions in receiving organizations own language for each department so that the manufacturing instructions can be used as a training material during the training in sending organization. For production item data the English version of the bill of materials needs to be fully in English. In addition it needs to be ensured that bill of materials is updated and these changes implemented before the training in sending organization begins.

State of Logistics and Operations Management in Finnish and Swedish Companies – Survey Research Findings

In this research we are examining what is the status of logistics and operations management in Finnish and Swedish companies. Empirical data is based on the web based questionnaire, which was completed in the end of 2007 and early 2008. Our examination consists of roughly 30 answers from largest manufacturing (highest representation in our sample), trade and logistics/distribution companies. Generally it could be argued that these companies operate in complex environment, where number of products, raw materials/components and suppliers is high. However, usually companies rely on small amount of suppliers per raw material/component (highest frequency is 2), and this was especially the case among Swedish companies, and among those companies, which favoured overseas sourcing. Sample consisted of companies which mostly are operating in an international environment, and are quite often multinationals. Our survey findings reveal that companies in general have taken logistics and information technology as part of their strategy process; utilization of performance measures as well as system implementations have followed the strategy decisions. In the transportation mode side we identify that road transports dominate all transport flow classes (inbound, internal and outbound), followed by sea and air. Surprisingly small amount of companies use railways, but in general we could argue that Swedish companies prefer this mode over Finnish counterparts. With respect of operations outsourcing, we found that more traditional areas of logistics outsourcing are driving factors in company's performance measurement priority. In contrary to previous research, our results indicate that the scope of outsourcing is not that wide in logistics/operations management area, and companies are not planning to outsource more in the near future. Some support is found for more international operations and increased outsourcing activity. From the increased time pressure of companies, we find evidence that local as well as overseas customers expect deliveries within days or weeks, but suppliers usually supply within weeks or months. So, basically this leads into considerable inventory holding. Interestingly local and overseas sourcing strategy does not have that great influence on lead time performance of these particular sourcing areas - local strategy is anyway considerably better in responding on market changes due to shorter supply lead times. In the end of our research work we have completed correlation analysis concerning items asked with Likert scale. Our analysis shows that seeing logistics more like a process rather than function, applying time based management, favouring partnerships and measuring logistics within different performance dimensions results on preferred features and performance found in logistics literature.

Sähköpostimyynnin erityispiirteet taloushallinnon näkökulmasta Case: Sanoma Magazines Finland Oy

Digitaalisten myyntikanavien käytön lisääntyminen suoramarkkinoinnissa ja kanavien tarjoamat mahdollisuudet ovat ajankohtainen aihe yritysmaailmassa. Digitalisoitumisen hyödyt yritykselle ovat myös uusi tutkimuskohde. Tutkimuksessa pyritään löytämään perinteisen ja digitaalisen kanavan erot sekä kuvaamaan sähköpostimyynnin erityispiirteet aikakauslehden tilausmyynnissä. Tutkimuksen näkökulmana on taloushallinnon kustannus-hyötytarkastelu. Tämän kvalitatiivisen tutkimuksen menetelmänä on tapaustutkimus ja kohdeyrityksenä Sanoma Magazines Finland Oy, jonka lehtituotteiden myynnin tietoja on kerätty pääasiassa havainnoimalla yrityksen eri järjestelmistä. Ilmiötä on tarkasteltu sähköiseen markkinointiin liittyvän lainsäädännön, strategia-ajattelun käsitteistön ja taloushallinnosta erityisesti kustannuslaskennan kautta. Empiriassa kuvataan kahden eri myyntikanavan myyntiprosessit. Vertailemalla eri kanavien viiden eri lehtituotteen kahden vuoden myynnin toimenpiteiden tunnuslukuja keskenään pyritään selvittämään ja kuvaamaan sähköpostimyynnin erityispiirteet.

Sähköisen taloushallinnon vaikutus tilitoimistojen tuottavuuteen Case: Heeros Systems Oy

Tässä tutkimuksessa tarkasteltiin tuottavuuden käsitettä ja mittaamista palvelualoilla. Tutkielman tavoitteena oli kuvata ja ymmärtää sähköisen taloushallinnon vaikutusta tilitoimistojen tuottavuuteen. Aihetta lähestyttiin sähköisiä taloushallinto-ohjelmia valmistavan case-yhtiö Heeros Systems Oy:n avulla. Tutkimus on luonteeltaan laadullinen tutkimus, jonka tutkimusmenetelmä-nä käytettiin teemahaastatteluja. Tutkimusaineisto kerättiin haastattelemal-la yhteensä kymmentä tutkimuksen kohteena olevan tilitoimiston edusta-jaa. Tutkimuksen perusteella ei havaittu sähköisen taloushallinnon selkeästi vaikuttavan tilitoimistojen tuottavuuteen tässä vaiheessa, mutta toiminto-ympäristön sähköistyessä, esimerkiksi verkkolaskujen yleistyessä, tilan-teen uskotaan muuttuvan nopeasti. Tällöin tuottavuuden kasvu edellyttää työprosessin muuttamista ja huolellista suunnittelua.

Territorialisation des politiques énergétiques dans l'agglomération franco-valdo-genevoise : la planification énergétique comme opportunité de réaménagement des zones frontières ?

La présente recherche traite des défis posés à l'action publique territoriale par la transition énergétique, transition désormais érigée au rang de priorité par les autorités françaises et suisses, comme plus globalement européennes. Elle prend pour cela appui sur une analyse des démarches de planification énergétique territoriale menées entre 2007 et 2014 sur le territoire franco-valdo-genevois (agglomération du « Grand-Genève »). Considérées comme des laboratoires d'expérimentation de la territorialisation des politiques énergétiques, ces démarches sont ici examinées selon une perspective institutionnaliste et pragmatiste visant à mettre lumière les éléments qui interviennent dans la délimitation du champ des possibles en matière d'action publique énergétique et territoriale. Ce positionnement découle des évolutions observées sur le territoire franco-valdo-genevois durant la période d'étude (chapitre 1). Il découle plus précisément du constat de récurrence de certains points de blocage rencontrés aussi bien dans les démarches de planification énergétique elles-mêmes que dans les travaux méthodologiques qui ont pu être réalisés parallèlement à ces démarches, dans le but d'en affiner les outils techniques et organisationnels de mise en oeuvre. Ainsi, le point de départ de la présente recherche est le constat selon lequel on peine tout autant à construire des solutions énergétiques appropriables et réalisables par les acteurs des territoires concernés qu'à reconfigurer les outils de production de ces solutions. De ce constat découle l'intérêt porté aux cadres institutionnels qui régissent ces planifications énergétiques territoriales. Définis comme l'ensemble des repères - formels et informels - qui rendent possibles en même temps qu'ils contraignent les interactions territorialisées entre les acteurs, ces cadres institutionnels sont placés au coeur de la grille de (re)lecture des expériences de planification énergétique territoriale établie au chapitre 2 de la thèse. En référence aux concepts institutionnalistes et pragmatistes sur lesquels elle prend appui, cette grille conduit à appréhender ces expériences comme autant d'enquêtes contribuant, à travers le travail de mobilisation et construction de représentations territoriales auquel elles donnent lieu, à l'équipement sociocognitif d'un champ d'intervention territorial spécifique. Partant de l'hypothèse selon laquelle les potentialités comme les limites associées à l'équipement sociocognitif de ce champ orientent les possibilités d'action collective, la réflexion consiste en une application de cette grille à une trentaine d'expériences de planification énergétique territoriale. Cette application s'effectue en deux temps, correspondant à deux niveaux de lecture de ces démarches. Le premier porte sur les dispositifs organisationnels et les modalités d'interactions entre les cultures d'action qu'elles réunissent (chapitre 3). Le second se concentre davantage sur les supports cognitifs (représentations territoriales) autour desquels se structurent ces interactions (chapitre 4). Présentés dans le dernier chapitre de la thèse (chapitre 5), les enseignements tirés de ce travail de réexamen des démarches franco-valdo-genevoises de planification énergétique territoriale sont de deux ordres. Ils portent d'abord sur les caractéristiques des cadres institutionnels existants, la manière dont ils orientent ces démarches et délimitent les évolutions possibles dans les modes d'action collective et plus particulièrement d'action publique qui y sont associés. Mais ils portent aussi sur les potentiels de changement associés à ces démarches, et sur les pistes envisageables pour mieux valoriser es potentiels, dont l'activation passe par des évolutions profondes des systèmes institutionnels en place. -- In France as in Switzerland, local authorities stand out as leading players of energy transition, a transition that requires an important renewal of public intervention instruments. It is the stakes and the conditions of such a renewal that the present work aims to examine, based on the experiments of territorial energy planning led on the franco-valdo-genevan cross-border territory. Conceived as initiatives of relocation of the energy supply system, these energy planning initiatives are examined through an institutionalist and pragmatic « reading template ». This « reading template » consists of seeing these energy planning initiatives as pragmatist inquiries aiming, through a collective work of cognitive equipment of the territorial franco-valdo-genevan field of intervention, at the reconstruction of the means of coordination between people about their material, organizational and political territory. It opens towards a double reading of the energy planning initiatives. The first one concentrates on the organizational dimension of these inquiries - i.e. on the cultures of action which they gather and the modalities of interaction between them - whereas the second focuses on the cognitive substance which represents the medium of the interactions. This double reading provides insights at various levels. The first one concerns the (cognitive) territorial field of intervention that these energy-planning experiments contribute to draw. A field which, although better and better characterized in its technical dimensions, remains at the same time limited and " deformed " so that it values more the fossil energy systems, from which we want to release ourselves, than the renewable ones, which we would like to replace them with. The second level of teaching concerns the processes of production of territorial knowledge (PPTK) which presides over the demarcation and « equipment » of the territorial field of intervention. Examined through the institutional norms and the culture of action at stake in them, this PPTK turns out to create a sociocognitive "cross-border" area, the kind of area that could shelter the desired reconfigurations...on the condition that they are beforehand correctly "equipped", in cognitive and also in organizational terms. The determining factor for the quality of this equipment is concentrated in the third category of teaching. Starting with the opportunities created by these energy planning experiments concerning the renewal of public intervention instruments, these elements also allow us to take a new look at the urban area project under construction in this cross-border territory, a project th t shows itself closely linked to the energy experiments through a common challenge of territorialisation.

Tomografia computadorizada da coluna lombar após artrodese com emprego de material metálico: avaliação da qualidade da imagem para diferentes algoritmos matemáticos

OBJETIVO: Selecionar os melhores algoritmos para o exame de coluna lombar na avaliação de artrodese com material metálico. MATERIAIS E MÉTODOS: Utilizou-se um equipamento de tomografia computadorizada de 16 fileiras de detectores. Imagens de dez pacientes foram reconstruídas com filtros 20, 40, 60 e 80 e realizadas reformatações em três dimensões e multiplanares com espessuras de 2 mm e 4 mm. Um total de 320 imagens foi avaliado por três experientes radiologistas, que deram notas de 1 a 5 (1 = não-aceitável; 2 = abaixo dos padrões; 3 = aceitável; 4 = acima da média; 5 = excelente). Além disso, foram realizadas medidas de ruído para correlação com o tipo de filtro utilizado. RESULTADOS: As médias do valor de ruído para reconstrução com 2 mm e filtros 20, 40, 60 e 80 foram de 24,7 ± 4,3; 35,5 ± 4,2; 106,0 ± 18,5 e 145,9 ± 26,9, respectivamente, e para 4 mm foram de 18,1 ± 2,4; 25,1 ± 4,6; 76,7 ± 17,2 e 106,6 ± 23,4. CONCLUSÃO: As imagens coloridas em três dimensões são mais bem visualizadas com filtro 20, entretanto, nas imagens em tons de cinza um filtro intermediário de 40 ou 60 pode ser útil para demonstrar os parafusos com maior detalhe. Para reconstruções multiplanares com espessura de 2 mm o filtro 40 é mais bem aceito, e para uma espessura de 4 mm um filtro 60 apresentou melhor qualidade.