Effect Estimation of an Innovative Nursing Intervention to Improve Delirium among Home-Dwelling Older Adults: A Randomized Controlled Pilot Trial.

AIMS: Estimating the effect of a nursing intervention in home-dwelling older adults on the occurrence and course of delirium and concomitant cognitive and functional impairment. METHODS: A randomized clinical pilot trial using a before/after design was conducted with older patients discharged from hospital who had a medical prescription to receive home care. A total of 51 patients were randomized into the experimental group (EG) and 52 patients into the control group (CG). Besides usual home care, nursing interventions were offered by a geriatric nurse specialist to the EG at 48 h, 72 h, 7 days, 14 days, and 21 days after discharge. All patients were monitored for symptoms of delirium using the Confusion Assessment Method. Cognitive and functional statuses were measured with the Mini-Mental State Examination and the Katz and Lawton Index. RESULTS: No statistical differences with regard to symptoms of delirium (p = 0.085), cognitive impairment (p = 0.151), and functional status (p = 0.235) were found between the EG and CG at study entry and at 1 month. After adjustment, statistical differences were found in favor of the EG for symptoms of delirium (p = 0.046), cognitive impairment (p = 0.015), and functional status (p = 0.033). CONCLUSION: Nursing interventions to detect delirium at home are feasible and accepted. The nursing interventions produced a promising effect to improve delirium.

Data collection and criticality analysis for cost effective maintenance during the life cycle of a flue gas line

Työn tarkoituksena oli kerätä käyttövarmuustietoa savukaasulinjasta kahdelta suomalaiselta sellutehtaalta niiden käyttöönotosta aina tähän päivään asti. Käyttövarmuustieto koostuu luotettavuustiedoista sekä kunnossapitotiedoista. Kerätyn tiedon avulla on mahdollista kuvata tarkasti laitoksen käyttövarmuutta seuraavilla tunnusluvuilla: suunnittelemattomien häiriöiden lukumäärä ja korjausajat, laitteiden seisokkiaika, vikojen todennäköisyys ja korjaavan kunnossapidon kustannukset suhteessa savukaasulinjan korjaavan kunnossapidon kokonaiskustannuksiin. Käyttövarmuustiedon keräysmetodi on esitelty. Savukaasulinjan kriittisten laitteiden määrittelyyn käytetty metodi on yhdistelmä kyselytutkimuksesta ja muunnellusta vian vaikutus- ja kriittisyysanalyysistä. Laitteiden valitsemiskriteerit lopulliseen kriittisyysanalyysiin päätettiin käyttövarmuustietojen sekä kyselytutkimuksen perusteella. Kriittisten laitteiden määrittämisen tarkoitus on löytää savukaasulinjasta ne laitteet, joiden odottamaton vikaantuminen aiheuttaa vakavimmat seuraukset savukaasulinjan luotettavuuteen, tuotantoon, turvallisuuteen, päästöihin ja kustannuksiin. Tiedon avulla rajoitetut kunnossapidon resurssit voidaan suunnata oikein. Kriittisten laitteiden määrittämisen tuloksena todetaan, että kolme kriittisintä laitetta savukaasulinjassa ovat molemmille sellutehtaille yhteisesti: savukaasupuhaltimet, laahakuljettimet sekä ketjukuljettimet. Käyttövarmuustieto osoittaa, että laitteiden luotettavuus on tehdaskohtaista, mutta periaatteessa samat päälinjat voidaan nähdä suunnittelemattomien vikojen todennäköisyyttä esittävissä kuvissa. Kustannukset, jotka esitetään laitteen suunnittelemattomien kunnossapitokustannusten suhteena savukaasulinjan kokonaiskustannuksiin, noudattelevat hyvin pitkälle luotettavuuskäyrää, joka on laskettu laitteen seisokkiajan suhteena käyttötunteihin. Käyttövarmuustiedon keräys yhdistettynä kriittisten laitteiden määrittämiseen mahdollistavat ennakoivan kunnossapidon oikean kohdistamisen ja ajoittamisen laitteiston elinaikana siten, että luotettavuus- ja kustannustehokkuusvaatimukset saavutetaan.

Phyllochron estimation in intercropped strawberry and monocrop systems in a protected environment

The phyllochron is defined as the time required for the appearance of successive leaves on a plant; this characterises plant growth, development and adaptation to the environment. To check the growth and adaptation in cultivars of strawberry grown intercropped with fig trees, it was estimated the phyllochron in these production systems and in the monocrop. The experiment was conducted in greenhouses at the University of Passo Fundo (28º15'41'' S, 52º24'45'' W and 709 m) from June 8th to September 4th, 2009; this comprised the period of transplant until the 2nd flowering. The cultivars Aromas, Camino Real, Albion, Camarosa and Ventana, which seedlings were originated from the Agrícola LLahuen Nursery in Chile, as well as Festival, Camino Real and Earlibrite, originated from the Viansa S.A. Nursery in Argentina, were grown in white polyethylene bags filled with commercial substrate (Tecnomax®) and evaluated. The treatments were arranged in a randomised block design and four replicates were performed. A linear regression was realized between the leaf number (LN) in the main crown and the accumulated thermal time (ATT). The phyllochron (degree-day leaf-1) was estimated as the inverse of the angular coefficient of the linear regression. The data were submitted to ANOVA, and when significance was observed, the means were compared using the Tukey test (p < 0.05). The mean and standard deviation of phyllochrons of strawberry cultivars intercropped with fig trees varied from 149.35ºC day leaf-1 ± 31.29 in the Albion cultivar to 86.34ºC day leaf-1 ± 34.74 in the Ventana cultivar. Significant differences were observed among cultivars produced in a soilless environment with higher values recorded for Albion (199.96ºC day leaf-1 ± 29.7), which required more degree-days to produce a leaf, while cv. Ventana (85.76ºC day leaf-1 ± 11.51) exhibited a lower phyllochron mean value. Based on these results, Albion requires more degree-days to issue a leaf as compared to cv. Ventana. It was conclude that strawberry cultivars can be grown intercropped with fig trees (cv. Roxo de Valinhos).

Concentrations of resveratrol and derivatives in foods and estimation of dietary intake in a Spanish population: European Prospective Investigation into Cancer and Nutrition (EPIC)-Spain cohort

Resveratrol has been shown to have beneficial effects on diseases related to oxidant and/or inflammatory processes and extends the lifespan of simple organisms including rodents. The objective of the present study was to estimate the dietary intake of resveratrol and piceid (R&P) present in foods, and to identify the principal dietary sources of these compounds in the Spanish adult population. For this purpose, a food composition database (FCDB) of R&P in Spanish foods was compiled. The study included 40 685 subjects aged 35-64 years from northern and southern regions of Spain who were included in the European Prospective Investigation into Cancer and Nutrition (EPIC)-Spain cohort. Usual food intake was assessed by personal interviews using a computerised version of a validated diet history method. An FCDB with 160 items was compiled. The estimated median and mean of R&P intake were 100 and 933 mg/d respectively. Approximately, 32% of the population did not consume RΠ The most abundant of the four stilbenes studied was trans-piceid (53·6 %), followed by trans-resveratrol (20·9 %), cis-piceid (19·3 %) and cis-resveratrol (6·2 %). The most important source of R&P was wines (98·4 %) and grape and grape juices (1·6 %), whereas peanuts, pistachios and berries contributed to less than 0·01 %. For this reason the pattern of intake of R&P was similar to the wine pattern. This is the first time that R&P intake has been estimated in a Mediterranean country.

Cost efficient extractive removal of birch pulp

Tämän diplomityön tarkoituksena oli selvittää kustannustehokkaita keinoja uuteaineiden vähentämiseksi koivusulfaattimassasta. Uuteaineet voivat aiheuttaa ongelmia muodostaessaan saostumia prosessilaitteisiin. Saostumat aiheuttavat tukkeumia ja mittaushäiriöitä, mutta irrotessaan ne myös huonontavat sellun laatua. Lopputuotteeseen joutuessaan ne voivat lisäksi aiheuttaa haju- ja makuhaittoja, joilla on erityistä merkitystä esimerkiksi valmistettaessa elintarvikekartonkeja. Tämä työ tehtiin Stora Enson sellutehtaalla, Enocell Oy:llä, Uimaharjussa. Teoriaosassa käsiteltiin uuteaineiden koostumusta ja niiden aiheuttamia ongelmia sellu– ja paperitehtaissa. Lisäksi koottiin aikaisempien tehdaskokeiden fysikaalisia ja kemiallisia keinoja vähentää koivu-uutetta. Tarkastelualueina olivat puunkäsittely, keitto, pesemö ja valkaisu. Kokeellisessa osassa suoritettiin esikokeita laboratorio- ja tehdasmittakaavassa, jotta saavutettaisiin käytännöllistä tietoa itse lopuksi tehtävää tehdasmittakaavan koetta varten. Laboratoriokokeissa tutkittiin mm. keiton kappaluvun, lisäaineiden ja hartsisaippuan vaikutusta koivu-uutteeseen. Lisäksi suoritettiin myös happo- (A) ja peretikkahappovaiheen (Paa) laboratoriokokeet. Tehdasmittakaavassa tarkasteltiin mm. keiton kappaluvun, pesemön lämpötilan, A-vaiheen, valkaisun peroksidi- ja Paa-vaiheen vaikutusta koivu-uutteeseen. Uutteenpoistotehokkuutta eri menetelmien välillä vertailtiin niin määrällisesti kuin rahallisesti. Uutteenpoistotehokkuudella mitattuna vertailuvaihe oli tehokkain pesemön loppuvaiheessa ja valkaisun alkuvaiheessa. Pesemön loppuvaiheessa uutteenpoistoreduktiot olivat noin 30 % ja valkaisun alkuvaiheessa 40 %. Peroksidivaihe oli tehokkain käytettynä valkaisun loppuvaiheessa noin 40 % reduktiolla. Kustannustehokkuudella mitattuna tehokkaimmaksi osoittautui A-vaihe yhdessä peroksidivaiheen kanssa. Säästöt vertailujaksoon verrattuna olivat noin 0.3 €/ADt. Lisäksi kyseinen yhdistelmä osoittautui hyväksi keinoksi säilyttää uutetaso alle maksimirajan kuitulinja 2:lla, kun kuitulinjalla 1 tuotettiin samanaikaisesti armeeraussellua.

Influence of heart motion on cardiac output estimation by means of electrical impedance tomography: a case study.

Electrical impedance tomography (EIT) is a non-invasive imaging technique that can measure cardiac-related intra-thoracic impedance changes. EIT-based cardiac output estimation relies on the assumption that the amplitude of the impedance change in the ventricular region is representative of stroke volume (SV). However, other factors such as heart motion can significantly affect this ventricular impedance change. In the present case study, a magnetic resonance imaging-based dynamic bio-impedance model fitting the morphology of a single male subject was built. Simulations were performed to evaluate the contribution of heart motion and its influence on EIT-based SV estimation. Myocardial deformation was found to be the main contributor to the ventricular impedance change (56%). However, motion-induced impedance changes showed a strong correlation (r = 0.978) with left ventricular volume. We explained this by the quasi-incompressibility of blood and myocardium. As a result, EIT achieved excellent accuracy in estimating a wide range of simulated SV values (error distribution of 0.57 ± 2.19 ml (1.02 ± 2.62%) and correlation of r = 0.996 after a two-point calibration was applied to convert impedance values to millilitres). As the model was based on one single subject, the strong correlation found between motion-induced changes and ventricular volume remains to be verified in larger datasets.

Aortic blood pressure measured via EIT: investigation of different measurement settings.

Electrical impedance tomography (EIT) allows the measurement of intra-thoracic impedance changes related to cardiovascular activity. As a safe and low-cost imaging modality, EIT is an appealing candidate for non-invasive and continuous haemodynamic monitoring. EIT has recently been shown to allow the assessment of aortic blood pressure via the estimation of the aortic pulse arrival time (PAT). However, finding the aortic signal within EIT image sequences is a challenging task: the signal has a small amplitude and is difficult to locate due to the small size of the aorta and the inherent low spatial resolution of EIT. In order to most reliably detect the aortic signal, our objective was to understand the effect of EIT measurement settings (electrode belt placement, reconstruction algorithm). This paper investigates the influence of three transversal belt placements and two commonly-used difference reconstruction algorithms (Gauss-Newton and GREIT) on the measurement of aortic signals in view of aortic blood pressure estimation via EIT. A magnetic resonance imaging based three-dimensional finite element model of the haemodynamic bio-impedance properties of the human thorax was created. Two simulation experiments were performed with the aim to (1) evaluate the timing error in aortic PAT estimation and (2) quantify the strength of the aortic signal in each pixel of the EIT image sequences. Both experiments reveal better performance for images reconstructed with Gauss-Newton (with a noise figure of 0.5 or above) and a belt placement at the height of the heart or higher. According to the noise-free scenarios simulated, the uncertainty in the analysis of the aortic EIT signal is expected to induce blood pressure errors of at least ± 1.4 mmHg.

Postnatal ontogenesis of the tibia. Implications for age and sex estimation

The growth of five variables of the tibia (diaphyseal length, diaphyseal length plus distal epiphysis, condylo-malleolar length, sagittal diameter of the proximal epiphysis, maximum breadth of the distal epiphysis) were analysed using polynomial regression in order to evaluate their significance and capacity for age and sex determination during and after growth. Data were collected from 181 (90♂ and 91♀) individuals ranging from birth to 25 years of age and belonging to three documented collections from Western Europe. Results indicate that all five variables exhibit linear behaviour during growth, which can be expressed by a first-degree polynomial function. Sexual significant differences were observed from age 15 onward in the two epiphysis measurements and condylo-malleolar length, suggesting that these three variables could be useful for sex determination in individuals older than 15 years. Strong correlation coefficients were identified between the five tibial variables and age. These results indicate that any of the studied tibial measurements is likely to serve as a useful source for estimating sub-adult age in both archaeological and forensic samples.

Structured sparsity for spatially coherent fibre orientation estimation in diffusion MRI.

We propose a novel formulation to solve the problem of intra-voxel reconstruction of the fibre orientation distribution function (FOD) in each voxel of the white matter of the brain from diffusion MRI data. The majority of the state-of-the-art methods in the field perform the reconstruction on a voxel-by-voxel level, promoting sparsity of the orientation distribution. Recent methods have proposed a global denoising of the diffusion data using spatial information prior to reconstruction, while others promote spatial regularisation through an additional empirical prior on the diffusion image at each q-space point. Our approach reconciles voxelwise sparsity and spatial regularisation and defines a spatially structured FOD sparsity prior, where the structure originates from the spatial coherence of the fibre orientation between neighbour voxels. The method is shown, through both simulated and real data, to enable accurate FOD reconstruction from a much lower number of q-space samples than the state of the art, typically 15 samples, even for quite adverse noise conditions.

Papaya seedlings growth using a low-cost, automatic watering controller

The study assessed growth and physiological parameters of 'Sunrise Golden' and 'Tainung 01' papaya seedlings grown in 280mL plastic tubes and watered using a low-cost automatic irrigation system adjusted to operate at substrate water tension for starting irrigation (STI) of 3.0, 6.0 or 9.0 kPa. The water depths applied by the dripping system and drainage were monitored during germination and seedling growth. Germination, emergence velocity index (EVI), leaf area, plant height, shoot and root dry weight, stomatal conductance, relative water content (RWC) and relative chlorophyll content (RCC) were evaluated. Soil nutrient levels were determined by electrical conductivity (EC). Water use efficiency (WUE) corresponded to the ratio of plant dry mass to depth of water applied. STI settings did not affect papaya germination or EVI. System configuration to 3.0 and 6.0 kPa STI exhibited the highest drainage and lowest EC and RCC, indicating soil nutrient loss and plant nutrient deficiency. Drainage was greater in tubes planted with the 'Tainung 01' variety, which developed smaller root systems and lower stomatal conductance than 'Sunrise Golden' seedlings. The highest values for shoot dry weight and WEU were obtained at 6.0 kPa STI for 'Sunrise Golden' (0.62 g and 0.69 g L-1) and at 9.0 kPa in 'Tainung 01' (0.35 g and 0.82 g L-1). RWC at 9.0 kPa STI was lower than at 3.0 kPa in both varieties. The results indicate that the low-cost technology developed for irrigation automation is promising. Even so, new studies are needed to evaluate low-flow irrigation systems as well as the nutrient and water needs of different papaya varieties.

Cost Models for Routing and Wavelength Assignment in Wavelength-Division Multiplexing Optical Net

WDM (Wavelength-Division Multiplexing) optiset verkot on tällä hetkellä suosituin tapa isojen määrän tietojen siirtämiseen. Jokaiselle liittymälle määrätään reitin ja aallonpituus joka linkin varten. Tarvittavan reitin ja aallon pituuden löytäminen kutsutaan RWA-ongelmaksi. Tämän työn kuvaa mahdollisia kustannuksen mallein ratkaisuja RWA-ongelmaan. Olemassa on paljon erilaisia optimoinnin tavoitteita. Edellä mainittuja kustannuksen malleja perustuu näillä tavoitteilla. Kustannuksen malleja antavat tehokkaita ratkaisuja ja algoritmeja. The multicommodity malli on käsitelty tässä työssä perusteena RV/A-kustannuksen mallille. Myöskin OB käsitelty heuristisia menetelmiä RWA-ongelman ratkaisuun. Työn loppuosassa käsitellään toteutuksia muutamalle mallille ja erilaisia mahdollisuuksia kustannuksen mallein parantamiseen.

Paperinvalmistuslinjan energiankulutuksen mittaaminen paperitehtaassa

Tämän diplomityön tarkoituksena on selvittää paperinvalmistuslinjan energiankulutusmittaus paperitehtaalla ja kehittää sen perusteella mittausmenetelmä. Tavoitteena on tutkia ja ohjeistaa mittaustapahtuma, kun apuna käytetään prosessimittauksia. Diplomityön teoriaosassa käsitellään paperinvalmistuslinjaa ja sen osaprosesseja sekä paperitehtaan prosessiohjausjärjestelmiä. Lisäksi työssä kerrotaan kirjallisuudesta löytyvistä paperitehtaan energiankulutusmittauksista, taseiden soveltamisesta paperinvalmistuslinjaan, osaprosessien energiankulutuskohteista ja energiakäytön arvioinnista. Näiden tietojen perusteella kehitetään mittausmenetelmä, joka soveltuu normaalituotannossa oleviin LWC-, SC-, sanomalehti-, kartonki- ja hienopaperinvalmistuslinjoihin sekä näiden osaprosesseille. Kehitettyä mittausmenetelmää testattiin case-tapauksiin ja kokemuksia kirjattiin ylös. Mittausmenetelmän suurin rajoite on prosessin paperitehdaskohtaisuus. Menetelmästä rajataan pois ilmanvaihto-, lämminvesi- ja jäähdytysvesijärjestelmien energiavirrat, koska näistä ei yleensä ole riittävästi mittauksia. LTO:ssa poistoilmasta talteen otettu energiavirta kuitenkin otetaan huomioon. Se vähentää korvausilman lämmittämiseen tarvittavaa energiaa. Diplomityössä selvisi, että paperivalmistuslinjan energiankulutusmittaus voidaan tehdä kustannustehokkaasti ja kattavasti hyödyntäen olemassa olevia prosessimittauksia. Mittaustuloksista on mahdollista laskea ominaisenergiankulutus, jota voidaan verrata toisiin linjoihin kun mittauksissa otetaan huomioon prosessin parametrit, mittalaitteiden mittausalue, ajankohta, mittapisteiden määrä ja sijainti.

Cost allocation of corporate IT-services

Cost allocation is an inescapable problem in nearly every organization and in nearly every facet of accounting. Within large corporations there are several different types of units, like profit-making business units and non-profit service units. In order to evaluate the performance of the business units and to fund the operations of service units, the expenses of service production need to be allocated to the business units benefiting from the services.The objective of this thesis was to find good and fair allocating factors for the costs of corporate wide IT services. In order to reach this objective, the cost allocation process was studied in general and an overview of cost structure was established. All possible cost driver candidates were mapped and their good and bad properties were weighed. The cost allocation problem was handled separately according to organizational division of corporate IT department: infrastructure, administrative systems, sales system and e-business. The emphasis was on two largest cost groups: infrastructure costs and sales system costs. As a result of the study an allocation model is presented. It contains categorization of the costs, selected cost drivers and cost distributions for the current year.