Immediate Decision-Making and Information Needs in Intensive Care Coordination

The aim of this study was to develop a theoretical model for information integration to support the deci¬sion making of intensive care charge nurses, and physicians in charge – that is, ICU shift leaders. The study focused on the ad hoc decision-making and immediate information needs of shift leaders during the management of an intensive care unit’s (ICU) daily activities. The term ‘ad hoc decision-making’ was defined as critical judgements that are needed for a specific purpose at a precise moment with the goal of ensuring instant and adequate patient care and a fluent flow of ICU activities. Data collection and research analysis methods were tested in the identification of ICU shift leaders’ ad hoc decision-making. Decision-making of ICU charge nurses (n = 12) and physicians in charge (n = 8) was observed using a think-aloud technique in two university-affiliated Finnish ICUs for adults. The ad hoc decisions of ICU shift leaders were identified using an application of protocol analysis. In the next phase, a structured online question¬naire was developed to evaluate the immediate information needs of ICU shift leaders. A national survey was conducted in all Finnish, university-affiliated hospital ICUs for adults (n = 17). The questionnaire was sent to all charge nurses (n = 515) and physicians in charge (n = 223). Altogether, 257 charge nurses (50%) and 96 physicians in charge (43%) responded to the survey. The survey was also tested internationally in 16 Greek ICUs. From Greece, 50 charge nurses out of 240 (21%) responded to the survey. A think-aloud technique and protocol analysis were found to be applicable for the identification of the ad hoc decision-making of ICU shift leaders. During one day shift leaders made over 200 ad hoc decisions. Ad hoc decisions were made horizontally, related to the whole intensive care process, and vertically, concerning single intensive care incidents. Most of the ICU shift leaders’ ad hoc decisions were related to human resources and know-how, patient information and vital signs, and special treatments. Commonly, this ad hoc decision-making involved several multiprofessional decisions that constituted a bundle of immediate decisions and various information needs. Some of these immediate information needs were shared between the charge nurses and the physicians in charge. The majority of which concerned patient admission, the organisation and management of work, and staff allocation. In general, the information needs of charge nurses were more varied than those of physicians. It was found that many ad hoc deci-sions made by the physicians in charge produced several information needs for ICU charge nurses. This meant that before the task at hand was completed, various kinds of information was sought by the charge nurses to support the decision-making process. Most of the immediate information needs of charge nurses were related to the organisation and management of work and human resources, whereas the information needs of the physicians in charge mainly concerned direct patient care. Thus, information needs differ between professionals even if the goal of decision-making is the same. The results of the international survey confirmed these study results for charge nurses. Both in Finland and in Greece the information needs of charge nurses focused on the organisation and management of work and human resources. Many of the most crucial information needs of Finnish and Greek ICU charge nurses were common. In conclusion, it was found that ICU shift leaders make hundreds of ad hoc decisions during the course of a day related to the allocation of resources and organisation of patient care. The ad hoc decision-making of ICU shift leaders is a complex multi-professional process, which requires a lot of immediate information. Real-time support for information related to patient admission, the organisation and man¬agement of work, and allocation of staff resources is especially needed. The preliminary information integration model can be applied when real-time enterprise resource planning systems are developed for intensive care daily management

RDA (Resource Description and Access) – kuvailuohjeiden kansainvälinen ja kansallinen käyttöönotto

Marjatta Autio-Tuulen esitys Kuvailun tiedotuspäivillä Helsingissä 20.3.2013.

Growth, biomass allocation and photosynthesis of Rolandra fruticosa (asteraceae) in response to shade

The effects of shade on growth, biomass allocation patterns and photosynthetic response was examined for Rolandra fruticosa (L.) Kuntze, a common perennial weed shrub in cultivated pastures and agricultural areas of Brazilian Amazonia, for plants grown in full sunlight and those shaded to 30 % of full sunlight over a 34-d period. Specific leaf area and leaf area ratio were higher for shade plants during all the experimental period. Shade plants allocated significantly less biomass to root tissue than sun plants and relative growth rate was higher in sun plants. Sun leaves had significantly higher dark respiration and light saturated rates of photosynthesis than shade leaves. The apparent quantum efficiency was higher for shade leaves, while light compensation point was higher for sun leaves. These results are discussed in relation to their ecological and weed management implications.

Project Resource Management in R&D Public Sector Organization

In R&D organizations multiple projects are executed concurrently. Problems arises in managing shared resources since they are needed by multiple projects simultaneously. The objective of this thesis was to study how the project and resource management could be developed in a public sector R&D organization. The qualitative research was carried out in the Magnetic Measurements section at CERN where the section measures magnets for particle accelerators and builds state of the art measurement devices for various needs. Hence, the R&D and measurement projects are very time consuming and very complex. Based on the previous research and the requirements from the organization the best alter- native for resource management was to build a project management information system. A centralized database was constructed and on top of it was built an application for interacting and visualizing the project data. The application allows handling project data, which works as a basis for resource planning before and during the projects are executed. It is one way to standardize the work-flow of projects, which strengthens the project process. Additionally, it was noted that the inner customer’s database, the measurement system and the new application needed to be integrated. Further integration ensures that the project data is received efficiently from customers and available not only within the application but also during the concrete work. The research results introduced a new integrated application, which centralizes the project information flow with better visibility.

Germination, initial growth, and biomass allocation in three native Cerrado species

The parameters of germination, initial growth, and biomass allocation of three native plant species of Cerrado (Copaifera langsdorffii, Dipteryx alata and Kielmeyera coriacea) were established. The species had germination percentages above 88% and average germination times longer than 139 hours. The average time for the opening of the first leaf pair was more than 538 hours for all three species. The average root length of C. langsdorffii and D. alata seedlings after 80 days of growth was around 40cm, four times larger than the average shoot length (<10cm), although the root and shoot biomasses were similar for both species. The average root length (>20cm) of K. coriacea seedlings was four times larger than the average shoot length (<5cm), and the root biomass was 243% greater than the shoot biomass. Increase in seedling biomass was sustained primarily by the cotyledons in C. langsdorffii and D. alata, which acted as reserve organs and showed progressive weight reductions. Increase in seedling biomass in K. coriacea was sustained primarily by photosynthesis, since the cotyledons showed no significant weight reduction, acting primarily as photosynthetic organs. The length of the root systems was at least four times larger than the length of the shoots parts in all three species. Higher investment in root length rather than in root biomass suggest that the initial growth of these species is primarily to ensure access to water resources, apparently putting off the function of the radicular system as storage organ.

Virtual Runtime Application Partitions for Resource Management in Massively Parallel Architectures

This thesis presents a novel design paradigm, called Virtual Runtime Application Partitions (VRAP), to judiciously utilize the on-chip resources. As the dark silicon era approaches, where the power considerations will allow only a fraction chip to be powered on, judicious resource management will become a key consideration in future designs. Most of the works on resource management treat only the physical components (i.e. computation, communication, and memory blocks) as resources and manipulate the component to application mapping to optimize various parameters (e.g. energy efficiency). To further enhance the optimization potential, in addition to the physical resources we propose to manipulate abstract resources (i.e. voltage/frequency operating point, the fault-tolerance strength, the degree of parallelism, and the configuration architecture). The proposed framework (i.e. VRAP) encapsulates methods, algorithms, and hardware blocks to provide each application with the abstract resources tailored to its needs. To test the efficacy of this concept, we have developed three distinct self adaptive environments: (i) Private Operating Environment (POE), (ii) Private Reliability Environment (PRE), and (iii) Private Configuration Environment (PCE) that collectively ensure that each application meets its deadlines using minimal platform resources. In this work several novel architectural enhancements, algorithms and policies are presented to realize the virtual runtime application partitions efficiently. Considering the future design trends, we have chosen Coarse Grained Reconfigurable Architectures (CGRAs) and Network on Chips (NoCs) to test the feasibility of our approach. Specifically, we have chosen Dynamically Reconfigurable Resource Array (DRRA) and McNoC as the representative CGRA and NoC platforms. The proposed techniques are compared and evaluated using a variety of quantitative experiments. Synthesis and simulation results demonstrate VRAP significantly enhances the energy and power efficiency compared to state of the art.

Adaptive Dynamics of Resource Specialization

Ecological specialization in resource utilization has various facades ranging from nutritional resources via host use of parasites or phytophagous insects to local adaptation in different habitats. Therefore, the evolution of specialization affects the evolution of most other traits, which makes it one of the core issues in the theory of evolution. Hence, the evolution of specialization has gained enormous amounts of research interest, starting already from Darwin’s Origin of species in 1859. Vast majority of the theoretical studies has, however, focused on the mathematically most simple case with well-mixed populations and equilibrium dynamics. This thesis explores the possibilities to extend the evolutionary analysis of resource usage to spatially heterogeneous metapopulation models and to models with non-equilibrium dynamics. These extensions are enabled by the recent advances in the field of adaptive dynamics, which allows for a mechanistic derivation of the invasion-fitness function based on the ecological dynamics. In the evolutionary analyses, special focus is set to the case with two substitutable renewable resources. In this case, the most striking questions are, whether a generalist species is able to coexist with the two specialist species, and can such trimorphic coexistence be attained through natural selection starting from a monomorphic population. This is shown possible both due to spatial heterogeneity and due to non-equilibrium dynamics. In addition, it is shown that chaotic dynamics may sometimes inflict evolutionary suicide or cyclic evolutionary dynamics. Moreover, the relations between various ecological parameters and evolutionary dynamics are investigated. Especially, the relation between specialization and dispersal propensity turns out to be counter-intuitively non-monotonous. This observation served as inspiration to the analysis of joint evolution of dispersal and specialization, which may provide the most natural explanation to the observed coexistence of specialist and generalist species.

Paperitehtaan toimitusketjun kustannus- ja pääoma-analyysi

Heikkenevä kysyntä sekä koveneva hintakilpailu erityisesti painopaperin markkinoilla on luonut paperinvalmistajalle haasteita kustannusten alentamisen sekä kannattavuuden parantamisen osalta. Sijaintinsa vuoksi yritys on halunnut erityisesti parantaa kustannustehokkuuttaan logistiikan osalta, minkä tueksi tämä diplomityö on tehty. Tutkimuksen tarkoituksena on analysoida paperitehtaan toimitusketjuja kustannusjohtamisen näkökulmasta. Tavoitteena on ollut arvioida kahden vaihtoehtoisen toimitusketjun, suoran ja välivarasto-toimituksen, vaikutusta syntyvien kustannusten, ketjuun sitoutuneen pääoman sekä asiakaskannattavuuden kautta. Tutkimus toteutettiin case-tutkimuksen kaltaisena soveltuvin osin, hyödyntämällä kvantitatiivisia menetelmiä. Projektia varten valittiin paperinvalmistajan painopaperin tuloslinjalta kymmenen kohdeasiakasta, joille vaihtoehtoisia toimitusketjuja voidaan soveltaa. Toimitusketjut rajattiin käsittämään valmiin tuotteen asiakastoimitukset ja niistä aiheutuvat kuluerät. Kustannus- ja pääoma-analyysin suunnittelussa hyödynnettiin toimitusketjuihin sekä kustannusjohtamiseen liittyvää teoreettista kirjallisuutta. Ensisijaisena viitekehyksenä kustannusten analysoinnissa sovellettiin toimintolaskentaa ja pääoman sitoutumisen arvioinnissa kiertoajan tunnuslukuja. Käsiteltävä informaatio kerättiin yrityksen sisäisistä raporteista sekä toiminnanohjausjärjestelmästä taulukkolaskentaohjelmaan, jossa laskelmat tehtiin. Tutkimuksen avaintuloksena kahdeksan case-asiakkaan kohdalla suora toimitus osoittautui kustannuksiltaan välivaraston kautta kulkevaa edullisemmaksi. Lisäksi havaittiin suoran toimituksen nopeuttavan teoriassa pääoman kiertoa toimitusketjussa lyhyemmän läpimenoajan ansiosta. Johtopäätöksenä kustannus- ja pääomahyötyjen vaikutuksen vuoksi suorien toimitusten hyödyntäminen on edullista soveltuvien asiakkaiden kohdalla. Tutkimuksessa kustannusinformaation kerääminen kokonaisvaltaisesti osoittautui haasteelliseksi, sillä kaikkien toimitusketjun kustannuserien tietoja ei ollut laajasti saatavilla. Toimeksiantajan näkökulmasta merkittävät kohteet jatkotutkimukselle ovat kustannusten oikeellisuuteen ja kohdistamiseen sekä asiakkaiden maksukäytäntöihin ja ehtoihin liittyvä seuranta.

Production unit’s overhead cost allocation with activity-based costing in food industry enterprise

The main objective of this Master’s thesis is to develop a cost allocation model for a leading food industry company in Finland. The goal is to develop an allocation method for fixed overhead expenses produced in a specific production unit and create a plausible tracking system for product costs. The second objective is to construct an allocation model and modify the created model to be suited for other units as well. Costs, activities, drivers and appropriate allocation methods are studied. This thesis is started with literature review of existing theory of ABC, inspecting cost information and then conducting interviews with officials to get a general view of the requirements for the model to be constructed. The familiarization of the company started with becoming acquainted with the existing cost accounting methods. The main proposals for a new allocation model were revealed through interviews, which were utilized in setting targets for developing the new allocation method. As a result of this thesis, an Excel-based model is created based on the theoretical and empiric data. The new system is able to handle overhead costs in more detail improving the cost awareness, transparency in cost allocations and enhancing products’ cost structure. The improved cost awareness is received by selecting the best possible cost drivers for this situation. Also the capacity changes are taken into consideration, such as usage of practical or normal capacity instead of theoretical is suggested to apply. Also some recommendations for further development are made about capacity handling and cost collection.

Market anomalies and tactical asset allocation: Utilising market anomalies in multiple asset class portfolios with the Black−Litterman model

This thesis discusses the basic problem of the modern portfolio theory about how to optimise the perfect allocation for an investment portfolio. The theory provides a solution for an efficient portfolio, which minimises the risk of the portfolio with respect to the expected return. A central feature for all the portfolios on the efficient frontier is that the investor needs to provide the expected return for each asset. Market anomalies are persistent patterns seen in the financial markets, which cannot be explained with the current asset pricing theory. The goal of this thesis is to study whether these anomalies can be observed among different asset classes. Finally, if persistent patterns are found, it is investigated whether the anomalies hold valuable information for determining the expected returns used in the portfolio optimization Market anomalies and investment strategies based on them are studied with a rolling estimation window, where the return for the following period is always based on historical information. This is also crucial when rebalancing the portfolio. The anomalies investigated within this thesis are value, momentum, reversal, and idiosyncratic volatility. The research data includes price series of country level stock indices, government bonds, currencies, and commodities. The modern portfolio theory and the views given by the anomalies are combined by utilising the Black-Litterman model. This makes it possible to optimise the portfolio so that investor’s views are taken into account. When constructing the portfolios, the goal is to maximise the Sharpe ratio. Significance of the results is studied by assessing if the strategy yields excess returns in a relation to those explained by the threefactormodel. The most outstanding finding is that anomaly based factors include valuable information to enhance efficient portfolio diversification. When the highest Sharpe ratios for each asset class are picked from the test factors and applied to the Black−Litterman model, the final portfolio results in superior riskreturn combination. The highest Sharpe ratios are provided by momentum strategy for stocks and long-term reversal for the rest of the asset classes. Additionally, a strategy based on the value effect was highly appealing, and it basically performs as well as the previously mentioned Sharpe strategy. When studying the anomalies, it is found, that 12-month momentum is the strongest effect, especially for stock indices. In addition, a high idiosyncratic volatility seems to be positively correlated with country indices on stocks.