Työkalu julkisen terveydenhuollon tietojärjestelmien hankintaan

Terveydenhuollon tietojärjestelmiin investoidaan entistä suurempia summia, mutta merkittävä määrä näistä investoinneista kuluu tehottomiin järjestelmiin tai järjestelmiin, jotka eivät pääse edes implementaatiovaiheeseen asti. Suurin osa julkisen puolen IT-hankkeista epäonnistuu. Suomessa terveydenhuollon tietojärjestelmät ovat 10–15 vuotta muita aloja jäljessä, ja kärsivät muun muassa käytettävyys ja integraatio-ongelmista. Ongelman on arveltu johtuvan osittain julkisen sektorin hankintaosaamisen tasosta. Tämä tutkimus pyrkii osaltaan parantamaan julkisen sektorin hankintaosaamista terveydenhuollon saralla, luomalla työkalun alueellisten tietojärjestelmäkokonaisuuksien hankinnan tueksi. Lisäksi tutkimuksessa pyritään syventämään käsitystä julkisen sektorin hankinnasta terveydenhuollon piirissä. Tutkimus on toteutettu konstruktiivista tutkimusotetta hyödyntäen. Tutkimuksessa on luotu, teorian pohjalta, analyyttiseen hierarkiaprosessi – malliin pohjautuva työkalu. Tutkimuksen aineistona käytettiin asiantuntijahaastatteluja terveydenhuollon, tietohallinnon ja akateemisen tutkimuksen parista. Tutkimuksen empiirisessä osassa työkalua on paranneltu, ja sen käytettävyyttä arvioitu kriittisesti. Empiriaosassa on myös keskitytty julkisen sektorin hankintaorganisaation ja hankinnan ymmärtämiseen. Tutkimuksessa luodulla työkalulla katsotaan olevan lisäarvoa terveydenhuollon tietojärjestelmien hankinnassa. Malli on helppokäyttöinen visuaalisuutensa ja analyyttisen otteensa ansiosta. Malli edistää kommunikaatiota hankintaorganisaatiossa ja parantaa kompromissivalmiutta. Mallin haasteet liittyvät mallin hierarkian verkostorakenteeseen ja päätösongelman monimutkaisuuteen. Tutkimuksen perusteella voidaan sanoa että Suomen julkisen sektorin tietojärjestelmähankinnoissa painotetaan hankinnan pehmeitä osa-alueita paljon enemmän kuin kovia osa-alueita. Tutkimuksessa saatu kustannusten pieni painoarvo on vahvasti ristiriitainen aikaisempien tutkimusten kanssa. Tutkimuksen tulosten mukaan, tietojärjestelmien kokonaisarkkitehtuuri ja käytettävyys ovat ensiarvoisen tärkeitä hankintojen onnistumisen kannalta.

Learning to Understand the Retailers - The New Approach of a Paperboard Manufacturer

The aim of the study is to expand networking between a packaging material manufacturer and retailers in order to develop products which appeal to brand owners and their customers. The in-built targets are to understand the retailer’s role in the value chain, clarify who makes packaging decision of private label products, and canvass the importance of sustainability. The present value chain of the packaging material manufacturer is reviewed first. It is assumed that sustainability could be a common interest, and The Consumer Goods Forum’s “A Global Language for Packaging and Sustainability” report is shortly discussed. The presentation of the most common packaging materials is based on a guide called “Packaging in the Sustainability Agenda: A Guide for Corporate Decision Makers”. The terms manufacturer’s brand and private label are defined. A retail value chain with emphasis on the role of customers as partners is introduced. The study area is the Nordic countries, and the information about Nordic retailers was provided first by desk research. The interviews were made in Finland, Sweden, Norway and Denmark. The study method is qualitative: the intention was to get initial insights, ideas and understandings. The results are compiled under the headings: sustainability, private labels, cooperation and packaging development. Also the reasons for good profitability of private labels are explained. Sustainability or responsibility is a key driver for innovation in the retail sector. Private labels have become brands. The ways of cooperation between a packaging material manufacturer and a retailer could be education and training. Packaging development is of great interest to retailers and they are willing to contribute.

Tilintarkastajan toiminnan jatkuvuutta koskeva lausunto - tilintarkastajien kokemuksia

Tutkimuksessa selvitetään tilintarkastajien kokemuksia ja havaintoja kansainvälisen tilintarkastusstandardi ISA 570 vaikutuksista tilintarkastusraportointiin ja taustatekijöitä, jotka vaikuttavat tilintarkastajan toiminnan jatkuvuudesta lausumiseen. Kirjallisuuskatsauksessa perehdytään tilintarkastuksen ja toiminnan jatkuvuuden aiempaan kirjallisuuteen ja tutkimukseen. Toiminnan jatkuvuutta tarkastellaan tilintarkastajan näkökulmasta huomioiden aihealueen lait ja säädökset sekä siihen liittyvät tilintarkastuksen teoriat kuten päämies- agentti- teoria. Empiirisessä osiossa tutkitaan haastattelututkimuksella mitkä kaikki tekijät vaikuttavat tilintarkastajan lausuntoon tai lausumattomuuteen toiminnan jatkuvuudesta. Aineisto kerättiin haastattelututkimuksella keväällä 2013. Tutkimuksessa nousi esiin, että taloudellisten aikojen heikentyminen ja yleisen huomion keskittyminen tilintarkastusvastuisiin ovat vaikuttaneet tilintarkastajan toiminnan jatkuvuutta koskevaan lausuntoon enemmän kuin aikaisemmat oikeudelliset tapaukset tai itse standardin ISA 570 lanseeraus vuonna 2009. Tutkimustulokset vahvistivat, että toiminnan jatkuvuuden antaminen on aina useiden tekijöiden summa, johon vaikuttaa muun muassa oikeudellisen uhan suuruus, asiakkuuden merkittävyys, tilintarkastajan etiikka ja lausunnon seuraukset. Tutkimuksessa tuli ilmi, että yleinen huomio toiminnan jatkuvuutta koskeviin asioihin on lisääntynyt eri sidosryhmien kuten rahoittajien toimesta.

Brainstem auditory-evoked potential in Boxer dogs

Brainstem auditory-evoked potential (BAEP) has been widely used for different purposes in veterinary practice and is commonly used to identify inherited deafness and presbycusis. In this study, 43 Boxer dogs were evaluated using the BAEP. Deafness was diagnosed in 3 dogs (2 bilateral and 1 unilateral) allowing the remaining 40 Boxers to be included for normative data analysis including an evaluation on the influence of age on the BAEP. The animals were divided into 2 groups of 20 Boxers each based on age. The mean age was 4.54 years (range, 1-8) in group I, and 9.83 years (range, 8.5-12) in group II. The mean latency for I, III, and V waves were 1.14 (±0.07), 2.64 (±0.11), and 3.48 (±0.10) ms in group I, and 1.20 (±0.12), 2.73 (±0.15), and 3.58 (±0.22) ms in group II, respectively. The mean inter-peak latencies for the I-III, III-V and I-V intervals were 1.50 (±0.15), 0.84 (±0.15), and 2.34 (±0.11) ms in group I, and 1.53 (±0.16), 0.85 (±0.15), and 2.38 (±0.19) ms in group II, respectively. Latencies of waves I and III were significant different between group I and II. For the I-III, III-V and I-V intervals, no significant differences were observed between the 2 groups. As far as we know, this is the first normative study of BAEP obtained from Boxer dogs.

Käyttövesivaraajan ekosuunnitteluvaatimusten merkityksen arvioiminen rakennusten energianhallinnassa

Työn lähtökohtana ovat veden lämmittimiä koskeva ekosuunnittelulainsäädäntö ja sen vaatiman testausjärjestelmän laatiminen. Työn tavoitteena on arvioida ekosuunnittelulainsäädännön vaikutusta varaajan toimintaan osana rakennusten energianhallintaa. Työssä laaditaan käyttövesivaraajalle tuoteryhmäkohtaisen ekosuunnittelulainsäädännön mukainen mittausjärjestelmä energiatehokkuuden, lämpimän veden saannon, vuosittaisen sähkönkulutuksen sekä energiamerkinnän määrittämiseksi. Lisäksi tarkastellaan ekosuunnittelulainsäädännön tarkoituksenmukaisuutta, selvitetään varaajan toimintaperiaatteet sekä keinoja käyttöveden tarvitseman energian vähentämiseksi. Testattu käyttövesivaraaja täyttää ekosuunnitteluvaatimukset. Lämmitysenergian vähentäminen käyttövesivaraajan toimintaa tehostamalla on kuitenkin vaikeaa. Hybridijärjestelmien hyödyntäminen sähkölämmityksen ohella muita energianlähteitä ja esim. käyttöveden lämmöntalteenottoa käyttäen on toimivin keino vähentää käyttöveden energiankulutusta sekä parantaa varaajan energiatehokkuutta. Lämpimän käyttöveden energiankulutuksen osuus rakennuksen energiankulutuksesta kasvaa lainsäädännön pakottamana rakennusten kokonaisenergiankäytön vähentyessä. Ekosuunnittelulainsäädännön suora merkitys rakennusten energianhallintaan on Suomessa vähäistä nykyisen energiatehokkuustason ollessa suhteellisen korkea, jolloin käyttöveden tarvitseman energian vähentämiskeinoina on hyödynnettävä vaihtoehtoisia ratkaisuja.

Homogeneous assay technologies in drug screening: Quenching Resonance Energy Transfer (QRET) technique

Information gained from the human genome project and improvements in compound synthesizing have increased the number of both therapeutic targets and potential lead compounds. This has evolved a need for better screening techniques to have a capacity to screen number of compound libraries against increasing amount of targets. Radioactivity based assays have been traditionally used in drug screening but the fluorescence based assays have become more popular in high throughput screening (HTS) as they avoid safety and waste problems confronted with radioactivity. In comparison to conventional fluorescence more sensitive detection is obtained with time-resolved luminescence which has increased the popularity of time-resolved fluorescence resonance energy transfer (TR-FRET) based assays. To simplify the current TR-FRET based assay concept the luminometric homogeneous single-label utilizing assay technique, Quenching Resonance Energy Transfer (QRET), was developed. The technique utilizes soluble quencher to quench non-specifically the signal of unbound fraction of lanthanide labeled ligand. One labeling procedure and fewer manipulation steps in the assay concept are saving resources. The QRET technique is suitable for both biochemical and cell-based assays as indicated in four studies:1) ligand screening study of β2 -adrenergic receptor (cell-based), 2) activation study of Gs-/Gi-protein coupled receptors by measuring intracellular concentration of cyclic adenosine monophosphate (cell-based), 3) activation study of G-protein coupled receptors by observing the binding of guanosine-5’-triphosphate (cell membranes), and 4) activation study of small GTP binding protein Ras (biochemical). Signal-to-background ratios were between 2.4 to 10 and coefficient of variation varied from 0.5 to 17% indicating their suitability to HTS use.

Uskonnon ja luonnontieteiden vuoropuhelua uuden ajan alussa

Kirjallisuusarvostelu

Fredrik Gabriel Hedbergin juhlavuoden satoa

Kirjallisuusarvostelu

Switchable Lanthanide Luminescence for Detection of Biomolecules

Binary probes are oligonucleotide probe pairs that hybridize adjacently to a complementary target nucleic acid. In order to detect this hybridization, the two probes can be modified with, for example, fluorescent molecules, chemically reactive groups or nucleic acid enzymes. The benefit of this kind of binary probe based approach is that the hybridization elicits a detectable signal which is distinguishable from background noise even though unbound probes are not removed by washing before measurement. In addition, the requirement of two simultaneous binding events increases specificity. Similarly to binary oligonucleotide probes, also certain enzymes and fluorescent proteins can be divided into two parts and used in separation-free assays. Split enzyme and fluorescent protein reporters have practical applications among others as tools to investigate protein-protein interactions within living cells. In this study, a novel label technology, switchable lanthanide luminescence, was introduced and used successfully in model assays for nucleic acid and protein detection. This label technology is based on a luminescent lanthanide chelate divided into two inherently non-luminescent moieties, an ion carrier chelate and a light harvesting antenna ligand. These form a highly luminescent complex when brought into close proximity; i.e., the label moieties switch from a dark state to a luminescent state. This kind of mixed lanthanide complex has the same beneficial photophysical properties as the more typical lanthanide chelates and cryptates - sharp emission peaks, long emission lifetime enabling time-resolved measurement, and large Stokes’ shift, which minimize the background signal. Furthermore, the switchable lanthanide luminescence technique enables a homogeneous assay set-up. Here, switchable lanthanide luminescence label technology was first applied to sensitive, homogeneous, single-target nucleic acid and protein assays with picomolar detection limits and high signal to background ratios. Thereafter, a homogeneous four-plex nucleic acid array-based assay was developed. Finally, the label technology was shown to be effective in discrimination of single nucleotide mismatched targets from fully matched targets and the luminescent complex formation was analyzed more thoroughly. In conclusion, this study demonstrates that the switchable lanthanide luminescencebased label technology can be used in various homogeneous bioanalytical assays.

Yvonne, Prinzessin von Burgund

Kantaesitys 15.9.1973.

ANTAGONISM IS THE PREDOMINANT EFFECT OF HERBICIDE MIXTURES USED FOR IMIDAZOLINONE-RESISTANT BARNYARDGRASS (Echinochloa crus-galli) CONTROL

ABSTRACTHerbicides mixtures are used in many situations without the adequate knowledge related with the effect on major target weeds. The objective of this study was to evaluate the effects of different herbicides mixtures used in irrigated rice in order to establish the adequate combinations for the prevention and management of herbicide resistance in barnyardgrass (Echinochloa crus-galli). Three experiments were performed at field conditions with all major post-emergent herbicides used in irrigated rice in Brazil. The first experiment was performed with barnyardgrass resistant to imidazolinone herbicides and herbicides applied at label rates. The second and third experiments were performed with barnyardgrass resistant and susceptible to imidazolinone herbicides applied at doses of 50 or 75% of the label rates. The occurrence of additive, synergistic and antagonistic effects was identified at 18, 18 and 64%, respectively, among the total of 50 different associations of herbicide and rates evaluated. In general, the mixture of ACCase inhibitors with ALS inhibitors, quinclorac, clomazone + propanil or thiobencarb resulted in antagonism. Sinergic mixtures were found in clomazone with propanil + thiobencarb, profoxydim with cyhalofop-butyl or clomazone, and quinclorac with imazapyr + imazapic, bispyribac-sodium or cyhalofop-butyl. The mixtures of quinclorac with profoxydim were antagonic. Rice grain yield varied according to the efficiency of weed control. Seveveral mixtures were effective for imidazolinone resistant barnyardgrass control.

MULTIPLE RESISTANCE OF Sagittaria montevidensis BIOTYPES TO ACETOLACTATE SYNTHASE AND PHOTOSYSTEM II INHIBITING HERBICIDES

ABSTRACT The objective of this research was to evaluate the occurance of multiple resistance of Sagittaria montevidensis (SAGMO) biotypes to acetolactate synthase (ALS) and photosystem II (PSII) inhibiting herbicides through dose-response experiments. The experiment was conducted in a greenhouse from October 2012 to March 2013, in Pelotas, RS. The experimental design was completely randomized, with four replications. Treatments were arranged in a triple factorial design: two biotypes of S. montevidensis(SAGMO 35 - susceptible to herbicides and SAGMO 32 - suspected to be multiple resistance to ALS and PSII inhibiting herbicides), four herbicides (penoxsulam, (imazethapyr+imazapic), bentazon and saflufenacil) and 8 rates of these herbicides (1/32x, 1/16x, 1/8x, 1/4x, 1/2x, 0x, 1x, 2x, 4x, 8x, 16x, 32x and 64x). SAGMO 32 biotype presented high levels of resistance to penoxsulam, (imazethapyr+imazapic) and bentazon. For a 50% reduction in dry matter of the resistant biotype rate of 138 and 2.46 times higher than the label required for the susceptible biotype of the herbicides (imazethapyr+imazapic) and bentazon, respectively, are required. Saflufenacil may be used successfully to controlSagittaria montevidensis resistant in irrigated rice.

Molecular Basis for Resistance to Fluazifop-P-Butyl in Itchgrass (Rottboellia cochinchinensis) from Costa Rica

Rottboellia cochinchinensis is an annual grass weed species known as itchgrass, or "caminadora" in America´s Spanish speaking countries, and has become a major and troublesome weed in several crops. The application of fluazifop-P-butyl at recommended rates (125 g a.i. ha-1) was observed to be failing to control itchgrass in a field in San José, Upala county, Alajuela province, Costa Rica. Plants from the putative resistant R. cochinchinensis population survived fluazifop-P-butyl when treated with 250 g a.i. ha-1 (2X label rate) at the three- to four-leaf stage under greenhouse conditions. PCR amplification and sequencing of partial carboxyl transferase domain (CT) of the acetyl-CoA carboxylase (ACCase) gene were used to determine the molecular mechanism of resistance. A single non-synonymous point mutation from TGG (susceptible plants) to TGC (putative resistant plants) that leads to a Trp-2027-Cys substitution was found. This Trp-2027-Cys mutation is known to confer resistance to all aryloxyphenoxyproprionate (APP) herbicides to which fluazifop-P-butyl belongs. To the best of our knowledge, this is the first report of fluazifop-P-butyl resistance and a mutation at position 2027 for a Costa Rican R. cochinchinensis population.

Effect of FSH and insulin on lipogenesis in cultures of Sertoli cells from immature rats

Follicle-stimulating hormone (FSH) and insulin regulate glycide metabolism in Sertoli cells, thus stimulating lactate production. These stimulatory effects of FSH and insulin do not require protein synthesis, suggesting a modulation of enzyme activity and/or regulation of glucose transport. The present investigation was performed to characterize the hormonal control of lipid metabolism in Sertoli cells. The data indicate that FSH and insulin have a regulatory effect on lipid metabolism in Sertoli cells. After 8 h of preincubation with insulin (5 µg/ml), the activity of the enzyme ATP-citrate lyase in cultured Sertoli cells was increased from 0.19 to 0.34 nmol NAD+ formed µg protein-1 min-1. FSH (100 ng/ml) had no effect on this enzyme. Glycerol phosphate dehydrogenase activity was not affected by any of the hormones tested. When Sertoli cells from 19-day old rats were incubated with [1,2­14C]acetate for 90 or 360 min, the [14C] label was present predominantly in triglyceride and phospholipid fractions with minor amounts in other lipids. In Sertoli cells pretreated for 16 h with insulin and FSH, an increase in acetate incorporation into lipids was observed. Most of the label was in esterified lipids and this percentage increased with the time of treatment; this increase was remarkable in triglycerides of control cells (18.8% to 30.6%). Since Sertoli cell triglycerides participate in the control of spermatogenesis, the present data suggest that the hormonal control of lipid metabolism in Sertoli cells is important not only for maintaining the energy of the cell itself, but also for the control of the spermatogenesis process.

Minimal doses of hydroxyurea for sickle cell disease

The use of hydroxyurea (HU) can improve the clinical course of sickle cell disease. However, several features of HU treatment remain unclear, including the predictability of drug response and determination of adequate doses, considering positive responses and minimal side effects. In order to identify adequate doses of HU for treatment of sickle cell disease, 10 patients, 8 with sickle cell anemia and 2 with Sß thalassemia (8SS, 2Sß), were studied for a period of 6 to 19 months in an open label dose escalation trial (10 to 20 mg kg-1 day-1). Hemoglobin (Hb), fetal hemoglobin (Hb F) and mean corpuscular volume (MCV) values and reticulocyte, neutrophil and platelet counts were performed every two weeks during the increase of the HU dose and every 4 weeks when the maximum HU dose was established. Reduction in the number of vasoocclusive episodes was also considered in order to evaluate the efficiency of the treatment. The final Hb and Hb F concentrations, and MCV values were significantly higher than the initial values, while the final reticulocyte and neutrophil counts were significantly lower. There was an improvement in the concentration of Hb (range: 0.7-2.0 g/dl) at 15 mg HU kg-1 day-1, but this concentration did not increase significantly when the HU dose was raised to 20 mg kg-1 day-1. The concentration of Hb F increased significantly (range: 1.0-18.1%) when 15 mg HU was used, and continued to increase when the dose was raised to 20 mg kg-1 day-1. The final MCV values increased 11-28 fl (femtoliters). However, reticulocyte (range: 51-205 x 109/l) and neutrophil counts (range: 9.5-1.3 x 109/l) obtained at this dose were significantly lower than those obtained with 15 mg kg-1 day-1. All patients reported a decrease in frequency or severity of vasoocclusive episodes. These results suggest that a hydroxyurea dose of 15 mg kg-1 day-1 seems to be adequate for treatment of sickle cell disease in view of the minimal side effects observed and the improvement in laboratory and clinical parameters.