Gender Might Be Factor for Student Admission in Two Brazilian Medical Schools

This is a secondary data-based study conducted to investigate whether gender is related to acceptance. Two Brazilian Medical Schools, Universities A and B, were studied. Their entrance exams (EE) were analysed and the number of candidates who took the EE was compared to the number of students admitted to the MS according to gender, in the period between 1995 and 2009. The same data from MS in the United States in 2011 was also evaluated. There was an increase in the percentage of female applicants but it did not correspond to the percentage of admitted students of the same gender. There was a trend of selecting men. At A, 39.3% of the applicants and 47% of the admitted students were men (OR = 1.37; CI95% = 1.24 – 1.51). In B, men represented 39.3% of the applicants and 65.4% of the admitted students (OR = 2.93; CI 95% = 2.76 – 3.11). This was not seen in US MS. The analysis of the EE suggests that the greater selection of men could be a product of EE format.

Public-Private Partnerships: Managing organizational change for acquiring value creative capabilities

The objective of the dissertation is to examine organizational responses of public actors to customer requirements which drive the transformation of value networks and promote public-private partnership in the electricity distribution industry and elderly care sectors. The research bridges the concept of offering to value networks where capabilities can be acquired for novel product concepts. The research contributes to recent literature, re-examining theories on interactions of customer requirements and supply management. A critical realist case study approach is applied to this abductive the research which directs to describe causalities in the analyzed phenomena. The presented evidence is based on three sources, which are in-depth interviews, archival analysis and the Delphi method. Service provision requires awareness on technology and functionalities of offering. Moreover, service provision includes interactions of multiple partners, which suggests the importance of the co-operative orientation of actors. According to the findings,portfolio management has a key role when intelligent solutions are implemented in public service provision because its concepts involve a variety of resources from multiple suppliers. However, emergent networks are not functional if they lack leaders who have access to the customer interface, have power to steer networks and a capability to build offerings. Public procurement policies were recognized to focus on a narrow scope in which price is a key factor in decisions. In the future, the public sector has to implement technology strategies and portfolio management, which mean longterm platform development and commitment to partnerships. On the other hand, the service providers should also be more aware of offerings into which their products will be integrated in the future. This requires making the customer’s voice in product development and co-operation in order to increase the interconnectivity of products.

Analysis of private natural heritage reserves as a conservation strategy for the biodiversity of the cocoa region of the southern State of Bahia, Brazil

Brazil was the first country in Latin America to establish and regulate this type of reserve, and there are currently more than 700 Private Nature Heritage Reserves (RPPN in Portuguese) officially recognized by either federal or state environmental agencies. Together, these RPPN protect more than a half million hectares of land in the country. The coastal forests in the southern part of Bahia State extend 100 to 200 km inland, gradually changing in physiognomy as they occupy the dryer inland areas. The coastal forest has been subjected to intense deforestation, and currently occupies less than 10% of its original area. For this work the creation processes of the RPPN were consulted to obtain the data creation time, size of property, the condition of the remaining forest, succession chain and the last paid tax. After that, interviews with the owners were made to confirm this data. Sixteen RPPN have been established in this region until 2005. Their sizes vary from 4.7 to 800 ha. Ten of these RPPN are located within state or federal conservation areas or their buffer zones. In spite of the numerous national and international conservation strategies and environmental policies focused on the region, the present situation of the cocoa zone is threatening the conservation of the region's natural resources. The establishment of private reserves in the cocoa region could conceivably improve these conservation efforts. This type of reserve can be established under a uniform system supported by federal legislation, and could count on private organizations.

Public-private partnership in marine litter waste management

Marine litter is an international environmental problem that causes considerable costs to coastal communities and the fishing industry. Several international and national treaties and regulations have provisions to marine litter and forbid disposal of waste into the sea. However, none of these regulations state a responsibility for public authorities to recover marine litter from the sea, like they do for marine litter that washes up on public beaches. In a financial evaluation of a value chain for marine litter incineration it was found out that the total costs of waste incineration are approximately 100 ─ 200 % higher than waste fees offered by waste contractors of ports. The high costs of incineration are derived from the high calorific value of marine litter and therefore a high incineration cost for the waste, and long distances between ports that are taking part in a project for marine litter recovery from the sea and an Energy-from-Waste (EfW) facility. This study provides a possible solution to diverting marine litter from landfills to more environmentally sustainable EfW use by using a public-private partnership (PPP) framework. PPP would seem to fit as a suitable cooperative approach for answering problems of current marine litter disposal in theory. In the end it is up to the potential partners of this proposed PPP to decide whether the benefits of cooperation justify the required efforts.

Pragmatic competence of Finnish learners of English: Meaning in interaction in secondary and upper secondary schools

Tutkin pro gradu -tutkielmassani englannin kielen oppijoiden pragmaattista kompetenssia. Tarkoitukseni oli selvittää, miten suomalaiset yläkoululaiset ja lukiolaiset osaavat käyttää englannin kieltä erilaisissa kommunikaatiotilanteissa. Tutkielmani voidaan sijoittaa välikielen pragmatiikan tutkimukseen. Halusin selvittää, millä tasolla suomalaisten oppijoiden pragmaattinen kompetenssi on ja kehittyykö se yläkoulun ja lukion välillä. Lisäksi tutkin, vaikuttavatko oppimisympäristö ja oppimismahdollisuudet oppijoiden kykyyn käyttää englannin kieltä. Toisin sanoen vertasin englantipainotteisilla luokilla olevia oppilaita formaalin opetuksen oppijoihin sekä tutkin, vaikuttavatko englanninkieliset vapaa-ajan aktiviteetit ja oppijoiden mahdolliset oleskelut englanninkielisissä maissa heidän pragmaattiseen kompetenssiinsa. Tutkimukseni kohderyhmä koostui yläkoulun kahdeksasluokkalaisista ja lukion toisen vuosikurssin opiskelijoista. Testasin neljä eri ryhmää, joissa oli sekä formaalissa opetuksessa olevia oppijoita (yksi ryhmä kahdeksasluokkalaisia ja yksi ryhmä toisen vuosikurssin opiskelijoita) että kielipainotteisten luokkien oppijoita (yksi ryhmä kahdeksasluokkalaisia ja yksi ryhmä toisen vuosikurssin opiskelijoita). Arvioin kohderyhmäni pragmaattista kompetenssia monivalintatestillä, jossa testattiin oppijoiden kykyä käyttää ja ymmärtää implikaatioita, tilannekohtaisia rutiineja sekä puheakteja. Taustakysymysten avulla selvitin, kuinka usein oppijat käyttivät englantia vapaa-aikanaan ja olivatko he vierailleet englanninkielisissä maissa. Tutkimustulokseni osoittavat, että suomalaisten yläkoululaisten ja lukiolaisten pragmaattinen kompetenssi oli korkea. Pragmaattinen kompetenssi kehittyi kahdeksasluokkalaisten ja lukion toisen vuosikurssin välillä. Kehitys oli suurempaa formaalissa opetuksessa kuin kielipainotteisilla luokilla. Englantipainotteisilla luokilla olevat oppilaat suoriutuivat testistä paremmin kuin formaalin opetuksen oppilaat. Tosin erot olivat tilastollisesti merkitseviä vain yläkoulussa. Tutkimuksessani siis päättelin, että vieraskielinen opetus vaikutti enemmän nuorempiin oppijoihin. Eri oppimismahdollisuudet osoittautuivat haastaviksi analysoida. Tulokset osoittivat, että vain englanninkielisessä maassa oleskelulla oli vaikutusta oppijoiden pragmaattiseen kompetenssiin. Kysyttäessä vapaa-ajan aktiviteettien merkitystä oppijat kuitenkin kertoivat, että ne auttoivat heitä testiin vastaamisessa enemmän kuin englanninopetuksessa käydyt asiat. Kouluissa tulisikin jatkossa painottaa yhä enemmän vuorovaikutteista kieltenopetusta.

Private Home Care in Municipal Service Systems – A Case Study among Finnish and Swedish Municipalities

The aim of this study is to assess the current and future preconditions for conducting private business in municipal service systems for home care in Lahti and Hyvinkää in Finland, and in Uppsala and Huddinge in Sweden. This study also aims to assess the implications of quality related issues on the preconditions for conducting private business in the service systems in question. The theories and the research methodologies of the study are based on the Business Model Generation and the Business Model Canvas -concepts. Also a couple of frameworks on implications of quality are applied and integrated into the study. The study is completed as a case study – with structured and identical approaches for all four municipalities. The analyses and assessments of the study are primarily qualitative, but supported by simple quantitative methodologies. The data of the study consists primarily of publicly available information, and secondarily of answers provided by the case-municipalities to multiple choice questions. The results of the study show that the service systems for home care among the case-municipalities are, from perspective of private companies, diverse with local characteristics. Both the premises for conducting private business and the quality-issues are in many respects different in the Finnish and the Swedish case-municipalities. This is partly due to differences in the national service systems; the service voucher system versus the system of choice. Still, it appears that the current preconditions for conducting private business in the service systems for home care, including the implications of quality, would be more favorable in Uppsala and Huddinge than in Lahti and Hyvinkää. On the other hand, the service systems are subject to changes, and the most positive and significant development is here forecasted for a Finnish case-municipality (Lahti). Communication of quality is clearly more advanced in the Swedish case-municipalities. The results of this study can be utilized in several ways, for instance by private companies interested in entering into service systems for home care, either in some of the case-municipalities, or in some other Finnish or Swedish municipalities. Also municipalities can apply the analyses of the study when designing, developing or evaluating their own service systems for home care.

Public and Private Sector Decision Makers Within the Rail Baltica Growth Corridor

Transport volumes have increased and will continue to increase in European Union. Even though the growth has not been equal between different transport modes. Most of the growth has been faced on road transport. European Union aims to balance the unbalanced market shares between the modes by gaining and supporting the competitiveness of railway and waterway transport. In EU railway transportation is seen as solution to increase safety in traffic and decrease the environmental impacts of transportation. The aim of this research is to figure out how it is possible to decrease the environmental impacts by the technology already in use. Main focus of this research is in intermodality and combining the road and railway transportation. This study aims also to figure out demands and expectations towards new Rail Baltica railway route connecting Tallinn and Berlin. The research is conducted by performing a literature review about decreasing environmental impacts and combining road and rail transport. Another viewpoint is taken from the possible effects of tourism to the passenger transport on rails. Knowledge gained by literature review is deepened by additional internet questionnaire study and expert interview study. In decreasing the environmental impacts of transportation electric trains are definitely the best option providing that the electricity is generated from renewable or carbon dioxide free sources. Decrease of environmental impacts has been reached also with acceptance of larger road transport vehicles. According to interviewed passenger transport experts, the whole route from Tallinn to Berlin may not be convenient to be used in passenger transport, just because the route is too long.. In EU freight is transported mainly with semi-trailer combinations, and that is why it could be logical if huckepack trains would be used on Rail Baltica. Huckepack train allows semi-trailers to be transported on rails with time efficient loading-unloading process. Overall, Rail Baltica project is experienced as a future-oriented one and new railway alignment is seen as great alternative option for transport modes using fossil fuels.

Increasing the percentage of vaginal birth in the private sector in Brazil through the redesign of care model

OBJETIVO: Implantar um novo modelo de cuidado ao parto e reduzir o percentual de cesarianas entre as gestantes da UNIMED Jaboticabal.MÉTODOS: Estudo descritivo desenvolvido em uma instituição do interior paulista, que teve início em 2012 e propôs o redesenho do modelo de cuidado ao parto com a revisão de todo o processo assistencial por meio da Ciência da Melhoria Contínua. Para medir os resultados das mudanças, foram selecionados nove indicadores e suas respectivas metas.RESULTADOS: O indicador de partos vaginais atingiu a meta de 40%, após sete meses do início da intervenção. Este indicador entre as gestantes do SUS atingiu 66%. A taxa de mortalidade perinatal decresceu 25% comparando-se 2012 a 2014 e a taxa de prematuridade foi de 3/100 nascidos vivos em 2014. O percentual de gestantes da UNIMED com 6 ou mais consultas de pré-natal atingiu 95%. Em relação aos custos hospitalares per capita referentes à assistência ao parto, notou-se um decréscimo de 27%, quando comparados os anos de 2012 e 2013. Tal queda não se sustentou e o custo hospitalar per capita, em 2014, retornou aos mesmos patamares de 2012. A remuneração dos obstetras registrou um acréscimo de 72%, se comparados os anos de 2012, 2013 e 2014. Houve queda de 61% dos custos com a unidade de terapia intensiva (UTI) neonatal, comparando os anos de 2012 e 2013. A taxa de admissão em UTI neonatal acompanhou a redução dos custos e foi de 55%, se comparados os anos de 2012 a 2014, entre as gestantes da UNIMED. Não houve o alcance da meta de 80% de participação das gestantes nos cursos de preparação para o nascimento. A porcentagem de gestantes satisfeitas e muito satisfeitas com a assistência ao parto atingiu 86%.CONCLUSÃO: Este projeto atingiu seus objetivos, reduzindo o percentual de cesarianas entre as gestantes da UNIMED Jaboticabal, e constituiu-se em um exemplo concreto da realização do triplo objetivo em saúde: melhorar a experiência dos envolvidos e os resultados de saúde de populações e indivíduos e realizar estas duas tarefas com menor custo, eliminando desperdícios assistenciais.

Logistics of North-West Russia and Rail Baltica: Standpoints of Private Sector

The main aims of the present report are to describe the current state of railway transport in Russia, and to gather standpoints of Russian private transportation logistics sector towards the development of new railway connection called Rail Baltica Growth Corridor, connecting North-West Russia with Germany through the Baltic States and Poland. North-West Russia plays important role not only in Russian logistics, but also wider European markets as in container sea ports handling is approx. 2.5 mill. TEU p.a. and handling volume in all terminals is above 190 million tons p.a. The whole transportation logistics sector is shortly described as an operational environment for railways – this is done through technical and economic angles. Transportation development is always going in line with economics of the country, so the analysis on economical development is also presented. Logistics integration of the country is strongly influenced by its engagement in the international trade. Although, raw material handling at sea ports and container transports (imports) are blossoming, domestic transportation market is barely growing (in long-term perspective). Thus, recent entrance of Russia into World Trade Organization (WTO) is analyzed theme in this research, as the WTO is an important regulator of the foreign trade and enabler of volume growth in foreign trade related transportation logistics. However, WTO membership can influence negatively the development of Russia’s own industry and its volumes (these have been uncompetitive in global markets for decades). Data gathering in empirical part was accomplished by semi-structured case study interviews among North-West Russian logistics sector actors (private). These were conducted during years 2012-2013, and research compiles findings out of ten case company interviews. Although, there was no sea port involved in the study, most of the interviewed companies relied in European Logistics within significant parts in short sea shipping and truck combined transportation chains (in Russian part also using railways). As the results of the study, it could be concluded that Rail Baltica is seen as possible transport corridor in most of the interviewed companies, if there is enough cargo available. However, interviewees are a bit sceptical, because major and large-scale infrastructural improvements are needed. Delivery time, frequency and price level are three main factors influencing the attractiveness of Rail Baltica route. Price level is the most important feature, but if RB can offer other advantages such as higher frequency, shorter lead times or more developed set of value-added services, then some flexibility is possible for the price level. Environmental issues are not the main criteria of today, but are recognized and discussed among customers. Great uncertainty exists among respondents e.g. on forthcoming sulphur oxide ban on Baltic Sea shipping (whether or not it is going to be implemented in Russia). Rather surprisingly, transportation routes to Eastern Europe and Mediterranean area are having higher value and price space than those to Germany/Central Europe. Border crossing operations (traction monopoly at rails and customs), gauge widths as well as unclear decision-making processes (in Russia), are named as hindering factors. Performance standards for European connected logistics among Russian logistics sector representatives are less demanding as compared to neighbourhood countries belonging to EU.

Diversification benefits for a Finnish non-industrial private forest investor: Real Estate Investment Trusts in the USA

This thesis examined both domestic and international forest investment options for a Finnish non-industrial private forest investor. The focus was on forest-based investment instruments. The influence of movements of currency exchange rates on foreign returns were also taken into account. Annual data from 1995 to 2011 was used. The main portfolio optimization model in this study was the Mean-Variance model but the results were also validated by using the Value at Risk and Expected Shortfall models. In addition, the exchange rate risk hedging was established by using one-week-maturity forward contracts. The results suggested that 75 % of the total wealth should be invested in Finnish private forests and the rest, 25 %, to a US REIT, in this case Rayonier. With hedging, the total return on the portfolio was 7.21 % (NIPF 5.3%) with the volatility of 6.63 % (NIPF 7.9%). Taxation supported US investments in this case. As a conclusion, a Finnish private forest investor may, as evidenced, benefit in diversifying a portfolio using REITs in the US.

Ihmisten johtaminen taistelussa : elokuva Saving Private Ryan johtamisen opettamisen työkaluna

Johtamisen opetuksessa yleensä käytetty menetelmä on pohjautunut dia- tai vielä perinteisempään kalvoesitykseen. Opetuksen elävöittämisessä sekä viretason ja motivaation ylläpitämisessä opetuksen aikana ei ole tapahtunut juurikaan kehitystä. Opiskelijoiden keskittyminen valuu hukkaan, kun kaikki tarmo pitää laittaa siihen, että pysyy hereillä opetuksen aikana. Elokuvien käyttö opetuksen apuna on hiljalleen vallannut jalansijaa itselleen. Kuitenkin niiden käyttö on edelleen hyvin rajallista, vaikka ne ovat äärimmäisen tehokas ja helppo keino sekä elävöittää että piristää opetusta. Tämän tutkimuksen tavoitteena on, selvittää yhden potentiaalisen vaihtoehdon, Saving Private Ryan – Pelastakaa sotamies Ryan, käytettävyyttä johtamisen opetuksen työkaluna ja apuvälineenä. Toisena tavoitteena tutkimukselle voidaan pitää ajatusta, että tämä tutkimus innostaisi aktiiviseen elokuvien tarkasteluun, varsinkin johtamisen opetuksen näkökulmasta sekä elokuvien käytäntöön soveltamiseen. Tutkimuksessa lähestyttiin edellä mainitun elokuvan kahta johtajaa, kapteeni Milleriä ja kersantti Horvathia. Tutkimuksen pääkysymykset oli suhteutettu heidän johtamiskäyttäytymisessä mahdollisesti esiintyvään syväjohtamiseen, syväjohtamisen malliin ja johtajalle luontaisiin ominaisuuksiin. Pääkysymysten tueksi tutkimukselle asetettiin myös alakysymyksiä, joiden avulla oli tarkoituksena selventää edellä mainittujen henkilöiden johtamisprosessin hallintaa, sotilaskuria ja alaisista huolenpitoa. Tutkimusmenetelmänä käytettiin perusanalyysimenetelmää, jota voidaan käyttää kaikissa laadullisissa tutkimuksissa. Kyseessä on sisällönanalyysi, tarkemmin sanottuna teorialähtöinen sisällönanalyysi. Tutkimuksen teoriaosan avulla rakennetut strukturoidut analyysirungot ohjasivat henkilöiden johtamiskäyttäytymisen analysointia. Tuloksien perusteella voidaan vilpittömästi todeta, että tulevaisuudessa elokuvien käyttö opetuksen apuna tulee näyttelemään suurta osaa. Elokuvat tuovat opetukseen tarvittavaa piristystä ja mahdollistavat esimerkiksi aktiivimonisteiden tehokkaan käytön.