525 research outputs found

    Kouvolan kaupungin talousjulkaisun visualisointi informaatiografiikan avulla

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    T√§ss√§ opinn√§ytety√∂ss√§ k√§sitell√§√§n Kouvolan kaupungin talousjulkaisun visualisointia informaatiografiikan ja piktogrammisuunnittelun avulla. Opinn√§ytety√∂n tutkimuksen kohteena ovat informaatiografiikan eri osa-alueet ja niiden hy√∂dynt√§minen sek√§ gridin eli taittopohjan suunnittelu. Lis√§ksi opinn√§ytety√∂ss√§ k√§yd√§√§n tiivistetysti l√§pi semiotiikkaa ja piktogrammien suunnittelua. Tutkimuksen tukena ovat kirjallisuus ‚Äď ja verkkol√§hteet. Tutkimusta havainnoidaan kuvaesimerkkien avulla. Opinn√§ytety√∂n produktiivisen suunnitteluty√∂n kohteena olivat Kouvolan kaupungin talousjulkaisujen eli Osavuosikatsauksen, Talousarvion sek√§ Tilinp√§√§t√∂ksen kansi-lehtien suunnittelu, Tilinp√§√§t√∂ksen tiivistelm√§n taittomalliehdotus sek√§ talousjulkaisuihin liittyv√§ symbolisarja. Opinn√§ytety√∂n tavoitteena oli suunnitella helposti ymm√§rrett√§v√§√§ informaatiografiikkaa Kouvolan kaupungin talousviestint√§julkaisujen informaatiografiikkaa p√§ivitt√§m√§ll√§

    Essays on managing cultural impacts in multinational projects

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    Cultural differences have become more perceivable at the same time as national borders have become less relevant and economic systems more dependent on each other. Current concepts about culture do not seem to help in understanding the differences and their effects in practice. Despite the previous efforts within the project management discipline, a large variety of concepts and the lack of practical solutions are leading to disregarding especially the innovation potential arising from multiculturalism. This thesis consists of a summary and three essays, which are based on three research settings exploited in parallel in the essays. The first essay illustrates the variety of cultural conditions causing challenges between unified project practices and the flexibility of action in individual projects. The second essay reveals the tactics of Finnish project managers when navigating in multicultural project encounters, and the third essay depicts key elements of cross-cultural competence by comparing the differences between the approaches of masters and novices in culturally slanted project encounters. The first attribute and at the same time limitation associated with the concept of culture is nation, which often (almost always in daily conversation) is used as an equivalent to the word culture. National culture has been found to be obsolescent when managing cultural diversity in a multinational business environment, although it can sometimes be a relevant unit of analysis if linked to, for example, the political and legal institutions of the nation. The external variations of cultural spheres cause problems internally when applying the unified project process model and take attention away from external challenges. Secondly, culture is basically seen as causing only challenges, that is, having a negative influence. Especially on the level of an organisation the actions were directed to decrease or eliminate the possible problems. The individual project managers, on the other hand, saw diversity as more fine-grained and sought the subsequent opportunities. Thirdly, both cultural and project management knowledge are context related. The project manager should be able to change the approach if necessary in the situation at hand

    Physicians' and nurses' experiences on EHR usability : Comparison between the professional groups by employment sector and system brand

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    Background: Usability associates with patient safety and quality of care. This article reports results from nationwide usability-focused survey studies for physicians and nurses in Finland. Earlier research has shown dissatisfaction and serious deficiencies, which hamper the efficient use of health information systems (HIS); however, evaluation studies covering the viewpoints of both user groups are practically lacking. Our study aimed at comparing end-users' experiences on the usability of electronic health record (EHR) systems by employment sector and EHR brand. Methods: To measure usability, we used the validated National Usability-focused HIS Scale (NuHISS). For this study, we selected 11 usability statements that relate to technical quality (n = 3), ease of use (n = 6), benefits (n = 1) and collaboration (n = 1), and were identical in both surveys. We report the responses from 3013 physicians and 2560 nurses working in public sector hospitals or primary care health centers in 2017. Results: Results in total and by healthcare sector showed notable differences between nurses' and physicians' experiences on usability of their EHR systems. Physicians were more satisfied than nurses on technical quality and learnability of the EHR-systems, while nurses experienced the ease of use better and were more satisfied with collaboration aspects than physicians. Two EHR brands used in hospitals appeared to have succeeded in supporting physician workflows, while two others used in health centers were more suitable for nurses' needs. Conclusions: Nurses' and physicians' experiences on EHR usability appear to vary more by EHR brand and employment sector rather than either professional group being generally more satisfied. Development of EHR systems should consider the perspectives of these two main user groups and their working contexts.Peer reviewe

    Neurologisten sairauksien vaikutus seksuaalisuuteen

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    Hermostolla on tärkeä merkitys seksuaalisuudessa ja seksuaalitoimintojen säätelyssä, joten moniin neurologisiin sairauksiin liittyy niiden ongelmia. Seksuaalitoimintojen vaikeutuminen voi johtua suoraan rakenteellisista muutoksista esimerkiksi selkäytimen vaurioituessa tai epäsuorasti neurologisten vaurioiden aiheuttaman toimintahäiriön kuten halvausoireiden tai koordinaatio-ongelmien vuoksi. Lisäksi toimintakykyyn vaikuttavat usein neurologisiin tauteihin tai niiden jälkitiloihin liittyvät mielialahäiriöt, kognitiiviset ongelmat ja persoonallisuuden muutokset. Merkittävimpiä seksuaalihäiriöitä aiheuttavia tekijöitä nuorilla aikuisilla ovat MS-tauti, selkäydinvammat ja osa epilepsian hoitoon käytettävistä lääkkeistä. Ikääntyneillä muun muassa aivoverenkiertohäiriöt ja neurodegeneratiiviset sairaudet, erityisesti Parkinsonin tauti, voivat heikentää seksuaalitoimintoja. Potilaan kokonaisvaltaisessa hoidossa on tärkeää muistaa seksuaalitoimintojen häiriön mahdollisuus. Hoitovaihtoehdot noudattavat samoja periaatteita kuin muissakin sairauksissa käytettävät vaihtoehdot.publishedVersionPeer reviewe

    Circulating TNF-Alpha and IL-6 Concentrations and TNF-Alpha -308 G‚ÄČ>‚ÄČA Polymorphism in Children with Premature Adrenarche

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    Premature adrenarche (PA), the early rise in adrenal androgen production leading to prepubertal signs of androgen action, has been connected with adverse metabolic features. The metabolic syndrome is characterized by low-grade inflammation which in turn is associated with increases in circulating proinflammatory cytokines, like tumor necrosis factor-alpha (TNF-őĪ) and interleukin-6 (IL-6). We tested the hypothesis that serum concentrations of TNF-őĪ and IL-6 are increased in PA by studying 73 children with PA and 98 age- and gender-matched controls. Serum TNF-őĪ and IL-6 concentrations were measured using a multiplex bead array. The subjects were genotyped for the TNF-őĪ gene -308 G‚ÄČ>‚ÄČA polymorphism (known to affect TNF-őĪ gene transcription), and genotype‚Äďphenotype associations were studied. The mean serum TNF-őĪ concentration was higher in the PA than control children (20.4 vs. 18.4‚ÄČpg/ml, P‚ÄČ=‚ÄČ0.048), whereas there was no significant difference in the mean serum IL-6 concentrations between the study groups. The difference in TNF-őĪ was not explained by excess body weight in the PA subjects as the difference remained significant after BMI-adjustment (P‚ÄČ=‚ÄČ0.038). In the PA group, TNF-őĪ concentration was not associated with metabolic-endocrine features, but high IL-6 was associated with lower birth weight. There was no difference in the genotype distribution of the TNF-őĪ gene -308 G‚ÄČ>‚ÄČA polymorphism between the PA and control groups. In conclusion, PA was associated with increased serum TNF-őĪ concentrations which, unexpectedly, were not connected with BMI or insulin resistance. The TNF-őĪ gene -308 G‚ÄČ>‚ÄČA polymorphism does not seem to be associated with the development of PA

    Sepelvaltimoiden pallolaajennushoidon tulokset ja vaikutus potilaiden vointiin ja oireisiin

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    Johdanto. Suomessa tehdään vuosittain yli 10 000 sepelvaltimoiden pallolaajennusta. Seurantatutkimuksia perkutaanisten sepelvaltimotoimenpiteiden vaikuttavuudesta on tehty niukasti. Selvitimme sepelvaltimoiden pallolaajennuksen tuloksia kolmen vuoden seurannan aikana. Aineisto ja menetelmät. Kaikkia Kuopion yliopistollisessa sairaalassa (KYS) vuosina 2006-2007 sepelvaltimoiden pallolaajennuksella hoidettua 875:tä potilasta seurattiin vuoden 2009 loppuun. Toimenpide- ja päätetapahtumatiedot kerättiin potilasasiakirjoista ja potilaille lähetettiin vointia kartoittava kysely. Tulokset. Potilaiden keski-ikä oli 65,9 vuotta. Kahdelle kolmannekselle pallolaajennus tehtiin sepelvaltimotautikohtauksen vuoksi. Kahdelle kolmasosalle potilaista asetettiin yksi bioaktiivinen tai lääkeainestentti. Kuolleisuus toimenpiteeseen tai viikon kuluessa kotiutuksesta oli 2,0 %, ja kolmen vuoden seuranta-aikana 11,3 %. Toimenpiteeseen liittyviä komplikaatioita oli 16,7 %:lla. Uusi pallolaajennus tehtiin seuranta-aikana 11,4 %:lle ja ohitusleikkaus 4,6 %:lle potilaista. Päätelmät. Pallolaajennuksella hoidettujen potilaiden toimenpidekomplikaatiot ja kuolleisuus kolmen vuoden kuluessa olivat matalaa kansainvälistä tasoa. Potilaiden vointi koheni pallolaajennuksella

    Rotation and torsion of the left ventricle with cardiovascular magnetic resonance tagging : comparison of two analysis methods

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    Background Left ventricle rotation and torsion are fundamental components of myocardial function, and several software packages have been developed for analysis of these components. The purpose of this study was to compare the suitability of two software packages with different technical principles for analysis of rotation and torsion of the left ventricle during systole. Methods A group of hypertrophic cardiomyopathy (HCM) patients (N = 14, age 43 +/- 11 years), mutation carriers without hypertrophy (N = 10, age 34 +/- 13 years), and healthy relatives (N = 12, age 43 +/- 17 years) underwent a cardiovascular magnetic resonance examination, including spatial modulation of magnetization tagging sequences in basal and apical planes of the left ventricle. The tagging images were analyzed offline using a harmonic phase image analysis method with Gabor filtering and a non-rigid registration-based free-form deformation technique. Left-ventricle rotation and torsion scores were obtained from end-diastole to end-systole with both software. Results Analysis was successful in all cases with both software applications. End-systolic torsion values between the study groups were not statistically different with either software. End-systolic apical rotation, end-systolic basal rotation, and end-systolic torsion were consistently higher when analyzed with non-rigid registration than with harmonic phase-based analysis (p <0.0001). End-systolic rotation and torsion values had significant correlations between the two software (p <0.0001), most significant in the apical plane. Conclusions When comparing absolute values of rotation and torsion between different individuals, software-specific reference values are required. Harmonic phase flow with Gabor filtering and non-rigid registration-based methods can both be used reliably in the analysis of systolic rotation and torsion patterns of the left ventricle.Peer reviewe
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