Psychological well-being of the parents and child development, behavior, and quality of life in very low birth weight infants

The parents of premature infants, especially the mothers, are at increased risk for distress. Infants born prematurely are at risk for developmental problems. The aim of this study was to investigate whether the psychological well-being of both parents is associated with child development in very low birth weight (VLBW, ≤1500g) children. The burden of prematurity-related morbidity to the children and to the family was also assessed. A cohort of 201 VLBW infants born during 2001–2006 in the Turku University Hospital, Finland, and their parents were studied (I–IV). One study included a control group (n=166) of full-term infants (IV). The psychological well-being of the parents was evaluated by assessments of depressive symptoms, parenting stress, the sense of coherence and general family functioning. Cognitive, behavioral, and socio-emotional development, and the health-related quality of life (HRQoL) of the children were determined when the children were 2 to 8 years old. The psychological well-being of the parents was associated with the cognitive, behavioral and social development of the VLBW children. The VLBW infants with prematurity-related morbidities had a poorer HRQoL and the general functioning of the family was inferior compared to the control children and their families. 64.5% of the VLBW children survived without morbidities. Most of the VLBW children did not have significant behavior problems (93%), had normal social skills (63%), had no emotional problems (64%), and had no problems in executive functioning (62%). Only 3% of the surviving VLBW infants had significant cognitive delay. In conclusion, the depressive symptoms and stress of the parents can be risk factors for disadvantageous child development, while a strong sense of coherence can be protective. Parents of the premature children with developmental delays might also experience more depressive symptoms and stress than other parents. Prematurity-related morbidities were a burden to the VLBW child as well as to the family.

Improving business processes in a globally dispersed make-to-order supply chain. Case study on outbound logistics in a Multinational Corporation

The purpose of this thesis is to find out how outbound logistics process can be improved by reducing unnecessary waste in a globally dispersed make-to-order (MTO) supply chain. The research problem was addressed by a multinational corporation that aims to find a solution for reducing unnecessary waste in their outbound logistics process. The focus is on customized products that are delivered via sea transportation. Theoretical framework for improving outbound logistics processes in globally dispersed MTO supply chain was created based on business process management, Porter’s value chain theory, value stream mapping and current reality tree. The empirical research was conducted by using constructive approach due to its ability to research a practical problem and to improve the existing practices. The data was collected from ten semi-structured interviews and three non-participant observations. By analysing the data and applying the theoretical framework, five types of waste were detected in the process that were seen to derive from six root causes. Practical solution was constructed to reduce the waste in the process by combining the existing literature with the ideas raising from empirical data. The results of this thesis suggest that a MNC with a globally dispersed MTO supply chain can improve its outbound logistics process by applying activities that enhance internal and external integration, collaboration and coordination, and increase predictability of the process. This research has practical relevance both for the case company as well as for other MNCs with globally dispersed MTO supply chains that aim to improve their outbound logistics processes. This research contributes to the BPM and CRA research by providing an evidence for their applicability in the new context.

Opettajattareksi sopimaton? Diskurssianalyysi seminaarien naisoppilaiden poikkeavuuden tulkinnasta ja kontrollista Suomessa 1860 -1960 -luvuilla

Tutkimus sijoittuu konstruktivismin ja kasvatuksen historian alueille. Tutkin diskurssianalyysin keinoin miten opettajiksi opiskelevien tyttö- ja naisoppilaiden poikkeavuuden tulkintoja on luotu, ylläpidetty ja uusinnettu 1860-1960 -lukujen Suomessa. Huomio on siinä miten opettajaseminaarien tyttö- ja naisoppilaiden käyttäytymistä on tulkittu poikkeavaksi opettajakokousten pöytäkirjojen teksteissä; miten poikkeavuutta on luotu diskursseilla - ja miten diskurssit ja niiden tulkinnat ovat olleet sukupuolitettuja. Tutkimusaiheeseen diskurssianalyysi soveltuu niin metodiksi kuin viitekehykseksikin, koska poikkeavuuden, normaalin ja epänormaalin rakentuminen tapahtuu kielenkäytön, vuorovaikutuksen ja sosiaalisen toiminnan keskinäisissä suhteissa. Pyrkimyksenä on tietoisuuden lisääminen niistä prosesseista, joissa näitä poikkeavuuden tulkintoja luotiin. Aineistoni koostuu rangaistustapauksista, jotka ovat kirjattu viiden opettajaseminaarin opettajakokousten pöytäkirjoihin vuosien 1863 - 1962 välisenä aikana. Rikkomustapauksia on yhteensä 1436, joista 194 tyttöoppilaiden tekemiä. Ajanjakso alkaa kansalaisyhteiskunnan ja kansanopetuksen synnystä ja päättyy peruskoulun alkuvaiheisiin. Vaikka seminaarien virallinen ja julkinen säännöstö oli kohdistettu yhtälailla nais- ja miesoppilaille, sisälsivät diskursseihin kätkeytyvät normistot seminaarien tyttö- ja naisoppilaille omat erilliset rajat, joiden ylittäminen teki heistä poikkeavia. Tyttö- ja naisoppilaiden poikkeavuus opettajaseminaareissa on ollut poikkeamista Jumalan säätämästä järjestyksestä, jossa naisella on määrätty paikkansa, asemansa ja tehtävänsä. Kun poika- ja miesoppilaiden normeista ja seminaarien säännöistä poikkeamisia on käsitelty opettajakokouksissa rikoksina, on tyttö- ja naisoppilaiden rikkeitä pyritty näkemään sairauden kaltaisina moraalia ja ymmärrystä heikentävinä tiloina. Ennen kaikkea ne ovat olleet rikkomuksia oikeanlaista naiseutta eli ”tosinaiseuden” mallia vastaan. Naisopettajuuden malli kansan äitinä ja mallikansalaisena sekä nöyrän, alistuvan, vaatimattoman ja säyseän ”tosinaisen” mallit olivat lähes yhdenmukaiset ja ne ovat luoneet ja ylläpitäneet tyttö- ja naisoppilaiden toiseutta. Diskurssit, joilla tätä toiseutta ylläpidettiin, elivät opettajaseminaarien pöytäkirjateksteissä liki sadan vuoden ajan vain painotuserojen muuttuessa hieman. Toivon työni herättävän pohdintaa siitä, mitä saattaisivat olla oman aikamme vastaavanlaiset itsestäänselvyydet, jotka otamme annettuina ja jotka kyseenalaistamattomina totuuksina rajoittavat niin kasvatettavien kuin kasvattajienkin omaksi itsekseen tulemista.

International Entrepreneurship in Bottom of the Pyramid Markets – Overcoming institutional constraints

Bottom of the pyramid (BoP) markets are an underserved market of approximately four billion people living on under $5 a day in four regional areas: Africa, Asia, Eastern Europe and Latin America. According to estimations, the BoP market forms a $5 trillion global consumer market. Despite the potential of BoP markets, companies have traditionally focused on serving the markets of developed countries and ignored the large customer group at the bottom of the pyramid. The BoP approach as first developed by Prahalad and Hart in 2002 has focused on multinational corporations (MNCs), which were thought of as the ones who should take responsibility in serving the customers at the bottom of the pyramid. This study challenges this proposition and gives evidence that also smaller international new ventures – entrepreneurial firms that are international from their birth, can be successful in BoP markets. BoP markets are characterized by a number of deficiencies in the institutional environment such as strong reliance on informal sector, lack of infrastructure and lack of skilled labor. The purpose of this study is to increase the understanding of international entrepreneurship in BoP markets by analyzing how international new ventures overcome institutional constraints in BoP markets and how institutional uncertainty can be exploited by solving institutional problems. The main objective is divided into four sub objectives. • To describe the opportunities and challenges BoP markets present • To analyze the internationalization of INVs to BoP markets • To examine what kinds of strategies international entrepreneurs use to overcome institutional constraints • To explore the opportunities institutional uncertainty offers for INVs Qualitative approach was used to conduct this study and multiple-case study was chosen as a research strategy in order to allow cross-case analysis. The empirical data was collected through four interviews with the companies Fuzu, Mifuko, Palmroth Consulting and Sibesonke. The results indicated that understanding of the wider institutional environment improves the survival prospects of INVs in BoP markets and that it is indeed possible to exploit institutional uncertainty by solving institutional problems. The main findings were that first-hand experience of the markets and grassroots levels of information are the best assets in internationalization to BoP markets. This study highlights that international entrepreneurs with limited resources can improve the lives of people at the BoP with their business operations and act as small-scale institutional entrepreneurs contributing to the development of the institutional environment of BoP markets.

Order and membrane organization in chlorhexidine-lipid mixtures /

Formulations of a general bactericidal agent, chlorhexidine, mixed with a phospholipid at different concentrations are investigated using ^H NMR spectroscopy on a chain-deuterated lipid analog. Lipid-chlorhexidine formulation is known to release the drug into an aqueous medium slowly, maintaining a comparable concentration of the drug for up to four times longer than a direct aqueous solution. The NMR data does not support the proposed liposomal entrapment of chlorhexidine in lipid compartments. Complex thermal history of the lipid-chlorhexidine preparations is investigated in detail. In preparation for a counterpart measurement, using ^H NMR of deuterated chlorhexidine mixed with protonated lipid, the synthesis of a deuterated analog of chlorhexidine is performed.

Effects of dietary restraint and oral contraceptives on bone strength and bone turnover in young women

ABSTRACT Introduction The purpose of this study was to assess specific osteoporosis-related health behaviours and physiological outcomes including daily calcium intake, physical activity levels, bone strength, as assessed by quantitative ultrasound, and bone turnover among women between the ages of 18 and 25. Respective differences on relevant study variables, based on dietary restraint and oral contraceptive use were also examined. Methods One hundred women (20.6 ± 0.2 years of age) volunteered to participate in the study. Informed written consent was obtained by all subjects prior to participation. The study and all related procedures were approved by the Brock University Research Ethics Board. Body mass, height, relative body fat, as well as chest, waist and hip circumferences were measured using standard procedures. The 10-item restrained eating subscale of the Dutch Eating Behaviour Questionnaire (DEBQ) was used to assess dietary restraint (van Strien et al., 1986). Daily calcium intake was assessed by the Rapid Assessment Method (RAM) (Hertzler & Frary 1994). Weekly physical activity was documented by the 4-item Godin Leisure-Time Exercise Questionnaire (Godin & Shephard 1985). Bone strength was determined from the speed of sound (SOS) as measured by QUS (Sunlight 7000S). SOS measurements (m/s) were taken of the dominant and non-dominant sides of the distal one third of the radius and the mid-shaft of the tibia. Resting blood samples were collected from all subjects between 9am and 12pm, in order to evaluate the impact of lifestyle factors on biochemical markers of bone turnover. Blood was collected during the early follicular phase of the menstrual cycle (approximately days 1-5) for all subjects. Samples were centrifliged and the serum or plasma was aliquoted into separate tubes and stored at -80°C until analysis. The bone formation markers measured were Osteocalcin (OC), bone specific alkaline phosphatase (BAP) and 25-OH vitamin D. The bone resorption markers measured were the carboxy (CTx) and amino (NTx) terminal telopeptides of type-I collagen crosslinks. All markers were assessed by ELISA. Subjects were divided into high (HDR) and low dietary restrainers (LDR) based on the median DEBQ score, and also into users (BC) and non-users (nBC) of oral contraceptives. A series of multiple one way ANOVA's were then conducted to identify differences between each set of groups for all relevant variables. A two-way ANOVA analysis was used to explore significant interactions between dietary restraint and use of oral contraceptives while a univariate follow-up analysis was also performed when appropriate. Pearson Product Moment Correlations were used to determine relationships among study variables. Results HDR had significantly higher BMI, %BF and circumference measures but lower daily calcium intake than LDR. There were no significant differences in physical activity levels between HDR and LDR. No significant differences were found between BC and nBC in body composition, calcium intake and physical activity. HDR had significantly lower tibial SOS scores than LDR in both the dominant and non-dominant sites. The post-hoc analysis showed that within the non-birth control group, the HDR had significantly lower tibial SOS scores of bone strength when compared to the LDR but Aere were no significant differences found between the two dietary restraint groups for those currently on birth control. HDR had significantly lower levels of OC than LDR and the BC group had lower levels of BAP than the nBC group. Consistently, the follow-up analysis revealed that within those not on birth control, subjects who were classified as HDR had significantly (f*<0.05) lower levels of OC when compared with LDR but no significant differences were observed in bone turnover between the two dietary restraint groups for those currently on birth control. Physical activity was not correlated with SOS scores and bone turnover markers possibly due to the low physical activity variability in this group of women. Conclusion This is the first study to examine the effects of dietary restraint on bone strength and turnover among this population of women. The most important finding of this study was that bone strength and turnover are negatively influenced by dietary restraint independent of relative body fat. In general, the results of the present thesis suggest that dietary restraint, oral contraceptive use, as well as low daily calcium intake and low physical activity levels were widespread behaviours among this population of college-aged women. The young women who were using dietary restraint as a strategy to lose weight, and thus were in the HDR group, despite their higher relative body fat and weight, had lower scores of bone strength and lower levels of markers of bone turnover compared to the low dietary restrainers. Additionally, bone turnover seemed to be negatively affected by oral contraceptives, while bone strength, as assessed by QUS, seemed unaffected by their use in this population of young women. Physical activity (weekly energy expenditure), on the other hand, was not associated with either bone strength or bone tiimover possibly due to the low variability of this variable in this population of young Canadian women.