Congenital muscular torticollis

Aim: The purpose of these studies was to undertake a survey of functional and cosmetic status in children treated for congenital muscular torticollis (CMT), to examine validity and reliability of the Muscle Function Scale (MFS), to find reference values for rotation and lateral flexion of the neck and muscle function of the lateral flexors in the neck for the normally developing infant, to investigate if infants with CMT are at higher risk of achieving the early motor milestones later compared to a control group of healthy infants and to investigate if treatment duration is affected when stretching is carried out by an experienced physiotherapist compared to parents. Methods: Range of motion (ROM) in neck rotation was measured with an arthrodial protractor. Lateral flexion was measured with the infant/child lying in supine on a big protractor. Muscle function of the lateral flexor muscles of the neck was measured with MFS, which was also tested for validity by a panel of experts. Physiotherapists and students tested intra-rater and inter-rater reliability of the MFS using photos. The presence of asymmetry of the face, posture and lateral band were observed and estimated according to a scoring sheet in study I. In study IV and V craniofacial asymmetry and head posture was assessed with the visual scale “severity assessment for plagiocephaly”. Motor development was assessed with Alberta Infant Motor Scale. A questionnaire about time spent in prone when awake and sleep position was used. Infants with CMT were randomized to stretching treatment by physiotherapist or parent in study V. Results: The majority of the children who had received earlier treatment for torticollis attained an overall excellent/good status and the most notable findings were remaining craniofacial asymmetry and asymmetry in muscle function. The MFS had high inter-rater and intra-rater reliability, weighted Kappa and intraclass correlation both >0.9. Reference values for the mean ROM in neck rotation in healthy infants were in mean 110° with SD 6,2° and a range of 100°-120°. In lateral flexion the mean ROM was 70° with SD 2,2° and a range of 65°-75°. Infants of two months of age had the mean muscle function score of 1, which increased to 3-4 at the age of ten months. Difference in scores on the left and right side were rare. Multiple regression analysis showed that infants in the CMT group had a significantly lower score at AIMS compared to the control group at two (p=0.03) and six months of age (p=0.05). Infants who spent ≥ three times daily in a prone position when awake, had significantly higher scores at AIMS than infants who spent less time in prone at two (p=0.001), six (p <0.001) and ten months of age (p <0.001). When stretching treatment was performed by an experienced physiotherapist the time to achieve satisfactory ROM in both rotation and lateral flexion was significantly (P<0.01) shorter compared to the parents group. Symmetrical head posture was achieved earlier (P=0.05) in the physiotherapist group than in the parent group Conclusion: Most children with CMT had an overall excellent/good status at follow up after physiotherapy treatment and the most notable findings were remaining craniofacial asymmetry and asymmetry in muscle function. The MFS was found to be valid and reliable. Infants under one year of age have good ROM in rotation and lateral flexion of the neck. Infants with CMT seem to be at higher risk of achieving the early motor milestones late compared with a healthy control group. However time spent in prone position seems to have a positive influence on this. Infants with CMT gained full ROM and symmetric head posture earlier when treated by an experienced physiotherapist compared to parents. Nevertheless parents can achieve a good result within a couple of months

Enhanced sensitization to animal, interpersonal, and intergroup fear-relevant stimuli (but no evidence for selective one-trial fear learning)

Selective sensitization has been proposed as an alternative explanation for enhanced responding to animal fear-relevant stimuli—snakes and spiders—during extinction of Pavlovian fear conditioning. The current study sought to replicate the phenomenon using a shock workup procedure as the sensitizing manipulation and to extend it to interpersonal and intergroup fear-relevant stimuli—angry faces and other-race faces. Assessment of selective sensitization was followed by a one-trial fear learning procedure. Selective sensitization, larger electrodermal responses to fear-relevant than to control stimuli after sensitization, or a larger increase in electrodermal responding to fear-relevant than to control stimuli after sensitization was observed across stimulus domains. However, the one-trial fear learning procedure failed to provide evidence for enhanced fear conditioning to fear-relevant stimuli. One-trial fear learning was either absent or present for fear-relevant and nonfear-relevant stimuli. The current study confirms that electrodermal responses to fear-relevant stimuli across stimulus domains are subject to selective sensitization

Multiple criteria decision analysis with consideration to place-specific values in participatory forest planning

The combination of multiple criteria decision analysis (MCDA) and participatory planning is an approach that has been applied in complex planning situations where multiple criteria of very different natures are considered, and several stakeholders or social groups are involved. The spatial character of forest planning problems adds further to the complexity, because a large number of forest stands are to be assigned different treatments at different points in time. In addition, experience from participatory forest planning indicates that stakeholders may think about the forest in terms of place-specific values rather than in forest-wide terms. The objective of this study was to present an approach for including place-specific values in MCDA-based participatory forest planning and illustrate the approach by a case study where the objective was to choose a multipurpose forest plan for an area of urban forest in northern Sweden. Stakeholder values were identified in interviews, and maps were used to capture place-specific spatial values. The nonspatial and nonplace-specific spatial values were formulated as criteria and used to build an objective hierarchy describing the decision situation. The place-specific spatial values were included in the creation of a map showing zones of different silvicultural management classes, which was used as the basis for creation of forest plan alternatives in the subsequent process. The approach seemed to work well for capturing place-specific values, and the study indicates that formalized methods for including and evaluating place-specific values in participatory forest planning processes should be developed and tested further

An integrated MCDA software application for forest planning : a case study in southwestern Sweden

Forest planning in Sweden today translates not only into planning of timber production, but also for the provision of other functions and services. Multi-criteria decision analysis (MCDA) methods provide a way to take also non-monetary values into account in planning. The purpose of this study was to gain experience on how to use a forest decision support system combined with an MCDA tool in practical forestry. We used a new forest planning tool, PlanWise, which includes an integrated MCDA module, PlanEval. Using the software, the decision maker can compare different forest plans and evaluate them against his/her objectives in a structured and analytical manner. The analysis thus provides a ranking of the alternatives based on the individual preferences of the decision maker. PlanEval and the MCDA planning process are described in a case study, where the manager of a forest estate in southwestern Sweden used the program to compare different forest plans made for the estate. In the paper, we analyze possibilities and challenges of this approach and identify problems such as the adherence to formal requirements of MCDA techniques and the difficulty of comparing maps. Possibilities to expedite an MCDA planning process further are also discussed. The findings confirm that integration of an MCDA tool with a forest decision support system is valuable, but requires expert assistance to be successful

Asennetun laitekantatiedon hyödyntäminen ennakoivan huollon kenttäpalveluprosessissa

This thesis explores how the flow of information should be improved in a preventive maintenance field service process. Its motivation stems from the growing pressure on capital goods manufacturers to servitize, and the difficulties experienced when servitizing. Due to the heterogeneity of customer inputs, which is inherent to services, efficient operations can only be achieved through improving the flow of information. Realized as a prescriptive single case study, the thesis provides a tool for analysing the flow of information, along with a performance measurement method for identifying under-and over-maintenance in the preventive maintenance context. The primary purpose of the developed tool is to tie information to value in order to facilitate investments in improving the flow of information. The tool was realized through building a literature framework, consisting of five constructs; information, decision, action, outcome and value. The literature framework was applied in the case analysis, where it revealed a set of challenges related to the flow of information. The most significant improvement potential was found in the way the preventive maintenance plans were created, as there were no subsequent attempts to evaluate the performance of these plans. The analysis resulted in eight design propositions, of which the first was intended to reach the untapped potential mentioned above, through introducing a learning mechanism to the process. The first design proposition was further analysed in an attempt to quantify the effect of its implementation. The proposed learning mechanism consists of two measures, which indicate whether the equipment specific maintenance plan in question should be adjusted. The two measures were tested using case company service data, which confirmed that the case company is on average over-maintaining its service base. Additionally the analysis indicated room for improvement where frequently failing equipment was subjected to less maintenance than equipment with no failures during the studied timespan. Aside of the case specific recommendations, the thesis contributes to several fields of research. In servitization research there has been a call for tools to manage the transition from pure manufacturer to servitized manufacturer, to which the developed tool is a direct answer. The quantification of over-maintenance is also a significant advancement in the field of preventive maintenance. Further contributions were made to the fields of installed base information and operational decision-making.Tämän diplomityön tavoitteena on analysoida ja kehittää kohdeyrityksen ennakoivan huollon kenttäpalveluprosessin asennetun laitekantatiedon hyödyntämistä. Tavoite kumpuaa investointihyödykkeitä valmistavien yritysten palvelullistumisesta, joka lisää palveluliiketoiminnan osuutta koko liiketoiminnasta. Palvelujen toiminnanohjaus eroaa tuotannon toiminnanohjauksesta pääasiallisesti siten, että tehokkuuden kannalta olennaista asiakassyötteen vaihtelua ei voida poistaa, vaan sitä on hallittava lisäämällä tiedonkulkua. Tässä case-tutkimuksessa kehiteltiin tiedonkulun analysointia helpottava työkalu, sekä ennakoivan huollon käyttöön tarkoitettu yli- ja alihuoltamisen mittaristo. Tiedonkulun analysointiin tarkoitettu työkalu kehitettiin tiedonkulkua parantavien investointien tueksi. Työkalu toteutettiin kirjallisuuteen perustuvana viitekehyksenä, jossa on viisi keskeistä käsitettä; tieto, päätöksenteko, toiminta, seuraukset ja arvo. Työkalun avulla kohdeyrityksen ennakoivan huollon prosessi analysoitiin, jonka seurauksena tunnistettiin joukko tiedonkulkuun liittyviä haasteita. Suurin parannuspotentiaali löytyi tavasta jolla ennakoivan huollon suunnitelmat luotiin, jossa haaste perustui siihen että luodun suunnitelman suorituskykyä ei luomisen jälkeen arvioitu. Analyysin perusteella kehiteltiin kahdeksan parannusehdotusta, joista ensimmäinen vastasi yllä mainittuun haasteeseen ehdottamalla prosessiin oppimisominaisuutta. Ensimmäisen parannusehdotuksen perusteella tehtiin jatko-analyysi, jonka tavoitteena oli parannusehdotuksen toteuttamisen vaikutusten tarkempi arviointi. Oppimisominaisuus pohjautuu kahteen mittariin, joiden perusteella ennakoivan huollon suunnitelmaa säädetään. Mittareita kokeiltiin kohdeyrityksen toimittamien huollon tietokantaotteiden avulla, joiden perusteella pystyttiin toteamaan että kohdeyritys keskimääräisesti ylihuoltaa huoltokantaansa. Lisäksi havaittiin että jatkuvasti vikaantuvia laitteita huollettiin joissain tapauksissa vähemmän kuin nollavikaisia. Kohdeyrityskohtaisten suositusten ohella diplomityö osallistuu tieteelliseen keskusteluun usealla tieteenalalla. Palvelullistumiskeskustelussa on peräänkuulutettu käytännön työkaluja joiden avulla yritykset voisivat edesauttaa palveluympäristöön sopeutumista, johon kehitetty työkalu on suora vasta us. Ali- ja ylihuollon mittaaminen taas on huoltotoiminnan tutkimuksessa merkittävä edistysaskel. Diplomityö edistää myös ymmärrystä asennetun laitekantatiedon ja operationaalisen paatoksenteon tutkimusalueilla

Kalvens utveckling från födsel till produktion

Syfte med detta arbete är att få reda på vilken skötsel som är bäst för kalvens utveckling och hälsa. I arbetet beskrivs olika faktorer som påverkar hurudan mjölkko det blir av kalven. Målet med detta arbete är att få fram de bästa sätten att sköta om kalvar. I arbetet beskrivs kalvens utveckling, utfodring, utrymmes krav, vanligaste sjukdomarna hos kalvar och när kalven blir en kviga. Av dessa faktorer skall det kunna beskriva vilken slags skötsel som är bäst för kalven. För att nå målet i arbetet används kvalitativ forskning och intervju med fyra olika ladugårdsföretagare. Från intervjuerna får man olika synpunkter av fyra olika personer. I arbetet kommer det fram att bra mjölkkor får man av välskötta kalvar. Om kalven har bra utfodring och bra skötsel har den en bra chans att bli en bra mjölkande ko. Det beskrivs också vilka metoder som är mindre bra med tanke på kalvens utveckling och hälsa.Tämän opinnäytetyön tarkoituksena on selvittää, mikä hoito on paras vasikan kehitykselle ja terveydelle. Työssä otetaan huomioon erilaisia tekijöitä, jotka vaikuttavat siihen millainen lehmä vasikasta tulee. Lopputyön tarkoituksena on löytää parhaimpia tapoja hoitaa vasikoita. Siinä kerrotaan vasikan ruokinnasta, tilavaatimuksista, vasikoiden yleisimmistä sairauksista ja milloin vasikasta tulee hieho. Edellä mainittujen aiheiden käsittelystä on tarkoitus saada kuva siitä, minkälainen hoito on vasikalle parasta. Tavoitteen saavuttamiseksi työssä käytetään kvalitatiivista tutkimustapaa ja haastattelu neljän karjanomistajan kanssa. Haastatteluista saadaan selville erilaisia näkemyksiä neljältä eri ihmiseltä. Opinnäytetyöstä selviää, että hyvän lypsylehmän saa hyvin hoidetusta vasikasta. Jos vasikka on hyvin ruokittu ja saanut parasta mahdollista hoitoa, on sillä mahdollisuus tulla hyväksi lypsylehmäksi. Tekstissä kerrotaan myös mitkä hoitotavat johtavat huonon vasikan kehittymiseen.The purpose of this work is to find out which care is best for the calf’s development and health. The work describes various factors that affect what kind of cow you get from the calf. The aim of this work is to find out the best way to handle calves. The work describes calf development, feeding, space requirements, common diseases among calves and describes how a calf becomes a heifer. These factors should describe what care the calf needs. In order to achieve this works goals, qualitative research and interviews will be used in the work. From these interviews, from the interviews you received views from four different people. In the work, it is clear that good dairy cows develop from well-kept calves. If the calf is well fed and well taken care of, it has a good chance to become a good dairy cow. The work also described witch methods are less good considering the development and health of the calf