Exploring Customer-Oriented Service Offerings in Public Health: Developing Integrated Health Care Services for Rural Areas

Väestön ikääntyminen pakottaa yhteiskunnan ja julkisen terveydenhuollon muutoksiin. Jotta ikääntyvien ihmisten kotona asuminen voidaan mahdollistaa, palvelujärjestelmän pitää mukautua muuttuvaan tilanteeseen. Tämän diplomityön tarkoituksena on tunnistaa asiakaslähtöisiä lähellä asiakasta tarjottavia palvelukokonaisuuksia. Tutkimuksen teoreettinen viitekehys muodostuu asiakasarvon luomisesta ja palvelutarjoamista. Tarkasteluryhmänä on Etelä-Karjalan alueen 60–90-vuotiaat ja käytetty aineisto on kerätty vastaajilta postitse lähetetyllä kyselyllä. Tutkimus on eksploratiivinen ja tulosten tulkinnassa on hyödynnetty määrällisen tutkimuksen ja verkostoanalyysin menetelmiä. Työn keskeisimmät tulokset ovat tunnistetut asiakassegmentit ja heidän tarpeidensa pohjalta muodostetut palvelupaketit. Tulokset indikoivat asiakkaiden tarpeita ja tuloksia on analysoitu myös tuottajan näkökulmasta. Empiiristen tulosten lisäksi teoriaviitekehystä on kehitetty eteenpäin, jotta palvelukeskeiset teoriat voidaan ymmärtää yritysten näkökulman lisäksi asiakkaan näkökulmasta.

From Persephone to Pan: D. H. Lawrence's mythopoeic vision of the integrated personality with special emphasis on the short fiction and other writings in the early nineteen twenties

This doctoral thesis was published in printed form in 1987. It was digitized from paper copy in 2013. Unfortunately on some pages the digitizaion process has not been complete, i.e there are some minor typographic erros on some pages.

Non-linear analysis of laminated metal matrix composites by an integrated micro/macro-mechanical model

The present paper describes an integrated micro/macro mechanical study of the elastic-viscoplastic behavior of unidirectional metal matrix composites (MMC). The micromechanical analysis of the elastic moduli is based on the Composites Cylinder Assemblage model (CCA) with comparisons also draw with a Representative Unit Cell (RUC) technique. These "homogenization" techniques are later incorporated into the Vanishing Fiber Diameter (VFD) model and a new formulation is proposed. The concept of a smeared element procedure is employed in conjunction with two different versions of the Bodner and Partom elastic-viscoplastic constitutive model for the associated macroscopic analysis. The formulations developed are also compared against experimental and analytical results available in the literature.

Mobile clinics in public health care: Integrated service offerings for rural elderly

This research is an analysis of the value and content of local service offerings that enable longer periods of living at home for elderly people. Mobile health care and new distribution services have provided an interesting solution in this context. The research aim to shed light on the research question, ‘How do we bundle services based on different customer needs?’ A research process consisting of three main phases was applied for this purpose. During this process, elderly customers were segmented, the importance of services was rated and service offerings were defined. Value creation and service offering provides theoretical framework for the research. The target group is South Karelia’s 60 to 90-year old individuals and the data has been acquired via a postal questionnaire. Research has been conducted as exploratory research utilizing the methods of quantitative and social network analysis. The main results of the report are identified customer segments and service packages that fits to the segments’ needs. The results indicate the needs of customers and the results are additionally analysed from the producer’s point of view. In addition to the empirical results, the used theory framework has been developed further in order for the service-related theories to be seen from the customer’s point of view and not just from the producer’s point of view.

Weed control under integrated nutrient management systems in faba bean (Vicia faba) production in Egypt

Two field experiments were conducted in two successive seasons, 2005/2006 and 2006/2007, to determine whether management can improve faba bean competitiveness with weeds, thus helping to achieve its yield potential. The experiment included five treatments, composed of organic and mineral fertilizers, alone and mixed at different rates, along with a control and six weed control treatments, including oxadiargyl, prometryn, hand hoeing treatments alone or mixed with the herbicides, and a nonweeded treatment (control).The herbicide treatments were not superior to the two hand-hoeing treatments. Using compost favored growth and yield of faba bean more than of weeds. Adding fertilizer also improved most yield parameters. Application of compost alone or combined with 50 or 100% of the recommended NPK rate improved faba bean growth in terms of net assimilation rate, specific leaf area, and leaf weight ratio as components of relative growth rate. This improvement in growth resulted in increase of seed yield, yield components and protein of faba bean. Faba bean yield performance improved under interactive fertilizer effects and weed control treatments as growth improved, as a result of nutrient release from fertilizers and weed control.

Microwave-assisted solvent extraction and analysis of shikimic acid from plant tissues

A better method for determination of shikimate in plant tissues is needed to monitor exposure of plants to the herbicide glyphosate [N-(phosphonomethyl)glycine] and to screen the plant kingdom for high levels of this valuable phytochemical precursor to the pharmaceutical oseltamivir. A simple, rapid, and efficient method using microwave-assisted extraction (MWAE) with water as the extraction solvent was developed for the determination of shikimic acid in plant tissues. High performance liquid chromatography was used for the separation of shikimic acid, and chromatographic data were acquired using photodiode array detection. This MWAE technique was successful in recovering shikimic acid from a series of fortified plant tissues at more than 90% efficiency with an interference-free chromatogram. This allowed the use of lower amounts of reagents and organic solvents, reducing the use of toxic and/or hazardous chemicals, as compared to currently used methodologies. The method was used to determine the level of endogenous shikimic acid in several species of Brachiaria and sugarcane (Saccharum officinarum) and on B. decumbens and soybean (Glycine max) after treatment with glyphosate. The method was sensitive, rapid and reliable in all cases.

Vapastii ohjelmoitavan automaatioyksikön suunnitteluprosessi

Rakennusautomaatiossa tulee esiin sovelluksia, joissa järjestelmän ohjaus-, säätö- tai valvontaratkaisun toteuttaminen ohjelmoitavilla logiikoilla ei ole riittävän edullista. Tällöin vaihtoehtona on oman laitteen suunnittelu. Työn tavoitteena oli suunnitella ja toteuttaa kustannustehokas CAN-väylään liitettävä vapaasti ohjelmoitava automaatioyksikkö. Suunnittelua ohjasivat asiakkaan laatimat vaatimusmäärittelyt. Niistä laitteen konfigurointimahdollisuudet ja piirilevyn tavoitekoko asettivat suurimmat haasteet laitteen suunnittelulle. Työn tuloksena toteutettiin asiakkaan tarpeisiin soveltuva automaatioyksikkö. Tavoitteisiin päästiin komponenttivalinnoilla ja hyödyntämällä tehokkaasti mikro-ohjaimen integroituja ominaisuuksia. Näiden avulla pystyttiin karsimaan monia yksiköitä, joita tavanomaisesti toteutetaan erilliskomponenteilla. Työssä perehdyttiin sulautetun järjestelmän elektroniikan tuotekehitysprosessiin ideasta prototyyppiin. Samalla on kuvailtu valittuja ratkaisuja sekä suunnittelussa tapahtuneita virheitä ja miten ne on ratkaistu.

Target audience and message alignment for integrated marketing communication of luxury products: entering the Chinese market

The purpose of this study is to identify opportunities to match marketing communication message strategies with the target audience characteristics in the Chinese luxury market entry context. Therefore, consumer behaviour and psychographic marketing segmentation fields are being reviewed in a holistic view in order to identify the similarities and connection points. Through the analysis of the messages in advertisements placed in a certain luxury and fine living magazine, message creation strategies are being anticipated.

Optimized Fast-FISH with a-satellite probes: acceleration by microwave activation

It has been shown for several DNA probes that the recently introduced Fast-FISH (fluorescence in situ hybridization) technique is well suited for quantitative microscopy. For highly repetitive DNA probes the hybridization (renaturation) time and the number of subsequent washing steps were reduced considerably by omitting denaturing chemical agents (e.g., formamide). The appropriate hybridization temperature and time allow a clear discrimination between major and minor binding sites by quantitative fluorescence microscopy. The well-defined physical conditions for hybridization permit automatization of the procedure, e.g., by a programmable thermal cycler. Here, we present optimized conditions for a commercially available X-specific a-satellite probe. Highly fluorescent major binding sites were obtained for 74oC hybridization temperature and 60 min hybridization time. They were clearly discriminated from some low fluorescent minor binding sites on metaphase chromosomes as well as in interphase cell nuclei. On average, a total of 3.43 ± 1.59 binding sites were measured in metaphase spreads, and 2.69 ± 1.00 in interphase nuclei. Microwave activation for denaturation and hybridization was tested to accelerate the procedure. The slides with the target material and the hybridization buffer were placed in a standard microwave oven. After denaturation for 20 s at 900 W, hybridization was performed for 4 min at 90 W. The suitability of a microwave oven for Fast-FISH was confirmed by the application to a chromosome 1-specific a-satellite probe. In this case, denaturation was performed at 630 W for 60 s and hybridization at 90 W for 5 min. In all cases, the results were analyzed quantitatively and compared to the results obtained by Fast-FISH. The major binding sites were clearly discriminated by their brightness

Biogas production in regional integrated biodegradable waste treatment – Possibilities for improving energy performance and reducing GHG emissions

The greatest threat that the biodegradable waste causes on the environment is the methane produced in landfills by the decomposition of this waste. The Landfill Directive (1999/31/EC) aims to reduce the landfilling of biodegradable waste. In Finland, 31% of biodegradable municipal waste ended up into landfills in 2012. The pressure of reducing disposing into landfills is greatly increased by the forthcoming landfill ban on biodegradable waste in Finland. There is a need to discuss the need for increasing the utilization of biodegradable waste in regional renewable energy production to utilize the waste in a way that allows the best possibilities to reduce GHG emissions. The objectives of the thesis are: (1) to find important factors affecting renewable energy recovery possibilities from biodegradable waste, (2) to determine the main factors affecting the GHG balance of biogas production system and how to improve it and (3) to find ways to define energy performance of biogas production systems and what affects it. According to the thesis, the most important factors affecting the regional renewable energy possibilities from biodegradable waste are: the amount of available feedstock, properties of feedstock, selected utilization technologies, demand of energy and material products and the economic situation of utilizing the feedstocks. The biogas production by anaerobic digestion was seen as the main technology for utilizing biodegradable waste in agriculturally dense areas. The main reason for this is that manure was seen as the main feedstock, and it can be best utilized with anaerobic digestion, which can produce renewable energy while maintaining the spreading of nutrients on arable land. Biogas plants should be located close to the heat demand that would be enough to receive the produced heat also in the summer months and located close to the agricultural area where the digestate could be utilized. Another option for biogas use is to upgrade it to biomethane, which would require a location close to the natural gas grid. The most attractive masses for biogas production are municipal and industrial biodegradable waste because of gate fees the plant receives from them can provide over 80% of the income. On the other hand, directing gate fee masses for small-scale biogas plants could make dispersed biogas production more economical. In addition, the combustion of dry agricultural waste such as straw would provide a greater energy amount than utilizing them by anaerobic digestion. The complete energy performance assessment of biogas production system requires the use of more than one system boundary. These can then be used in calculating output–input ratios of biogas production, biogas plant, biogas utilization and biogas production system, which can be used to analyze different parts of the biogas production chain. At the moment, it is difficult to compare different biogas plants since there is a wide variation of definitions for energy performance of biogas production. A more consistent way of analyzing energy performance would allow comparing biogas plants with each other and other recovery systems and finding possible locations for further improvement. Both from the GHG emission balance and energy performance point of view, the energy consumption at the biogas plant was the most significant factor. Renewable energy use to fulfil the parasitic energy demand at the plant would be the most efficient way to reduce the GHG emissions at the plant. The GHG emission reductions could be increased by upgrading biogas to biomethane and displacing natural gas or petrol use in cars when compared to biogas CHP production. The emission reductions from displacing mineral fertilizers with digestate were seen less significant, and the greater N2O emissions from spreading digestate might surpass the emission reductions from displacing mineral fertilizers.

An optically coupled power stimulus isolation unit with high voltage and fast rise time output

Recent technological developments have created new devices that could improve and simplify the construction of stimulus isolators. HEXFET transistors can switch large currents and hundreds of volts in nanoseconds. The newer opto-isolators can give a pulse rise time of a few nanoseconds, with output compatible with MOSFET devices, in which delays are reduced to nanoseconds. Integrated DC/DC converters are now available. Using these new resources we developed a new electrical stimulus isolator circuit with selectable constant-current and constant-voltage modes, which are precise and easy to construct. The circuit works like a regulated power supply in both modes with output switched to zero or to free mode through an opto-isolator device. The isolator analyses showed good practical performance. The output to ground resistance was 1011 ohms and capacitance 35 picofarads. The rise time and fall time were identical (5 µs) and constant. The selectable voltage or current output mode made it very convenient to use. The current mode, with higher output resistance values in low current ranges, permits intracellular stimulation even with tip resistances close to 100 megaohms. The high compliance of 200 V guarantees the value of the current stimulus. The very low output resistance in the voltage mode made the device highly suitable for extracellular stimulation with low impedance electrodes. Most importantly, these characteristics were achieved with a circuit that was easy to build and modify and assembled with components available in Brazil.

Mechanisms in anti-inflammation and resolution: the role of lipoxins and aspirin-triggered lipoxins

Multicellular host responses to infection, injury or inflammatory stimuli lead to the formation of a broad range of chemical mediators by the host. The integrated response of the host is essential to health and disease; thus it is important to achieve a more complete understanding of the molecular and cellular events governing the formation and actions of endogenous mediators of resolution that appear to control the duration of inflammation. Lipoxins are trihydroxytetraene-containing lipid mediators that can be formed during cell-cell interactions and are predominantly counterregulators of some well-known mediators of inflammation. Since this circuit of lipoxin formation and action appears to be of physiological relevance for the resolution of inflammation, therapeutic modalities targeted at this system are likely to have fewer unwanted side effects than other candidates and current anti-inflammatory therapies. Here, we present an overview of the recent knowledge about the biosynthesis and bioactions of these anti-inflammatory lipid mediators.

Optimization and Measuring Techniques for Collect-and-Place Machines in Printed Circuit Board Industry

This thesis considers optimization problems arising in printed circuit board assembly. Especially, the case in which the electronic components of a single circuit board are placed using a single placement machine is studied. Although there is a large number of different placement machines, the use of collect-and-place -type gantry machines is discussed because of their flexibility and increasing popularity in the industry. Instead of solving the entire control optimization problem of a collect-andplace machine with a single application, the problem is divided into multiple subproblems because of its hard combinatorial nature. This dividing technique is called hierarchical decomposition. All the subproblems of the one PCB - one machine -context are described, classified and reviewed. The derived subproblems are then either solved with exact methods or new heuristic algorithms are developed and applied. The exact methods include, for example, a greedy algorithm and a solution based on dynamic programming. Some of the proposed heuristics contain constructive parts while others utilize local search or are based on frequency calculations. For the heuristics, it is made sure with comprehensive experimental tests that they are applicable and feasible. A number of quality functions will be proposed for evaluation and applied to the subproblems. In the experimental tests, artificially generated data from Markov-models and data from real-world PCB production are used. The thesis consists of an introduction and of five publications where the developed and used solution methods are described in their full detail. For all the problems stated in this thesis, the methods proposed are efficient enough to be used in the PCB assembly production in practice and are readily applicable in the PCB manufacturing industry.