Ennusteiden laatiminen Visma Navita Yritys-mallilla Diacor terveyspalvelut Oy:ssä

Tämän opinnäytetyön tarkoituksena on tutkia, kuinka analysointi- ja ennusteohjelma Visma Navita Yritysmalli tukee kohdeyrityksen johdossa tapahtuvaa päätöksentekoa sekä kartoittaa mahdollisia kehityskohteita. Tutkimuksen kohdeyritykseksi on valittu Diacor terveyspalvelut Oy, joka on pääkaupunkiseudulla toimiva yksityisiä terveyspalveluita tuottava yritys. Teoreettinen viitekehys muodostuu palveluliiketoiminnasta, talousohjauksesta sekä tietojärjestelmistä. Palveluliiketoiminnan teorian avulla voidaan hahmottaa kohdeyrityksen toimintaa ja sitä kautta saadaan näkökulmaa yrityksen taloudelliseen rakenteeseen. Jotta voidaan ymmärtää talousohjauksen merkitys yritysjohdon päätöksenteon prosessissa, käydään läpi, mistä osatekijöistä talousohjaus muodostuu ja miten se teoriassa avustaa yrityksen toimintaa. Tietojärjestelmiä on olemassa lukuisia ja monissa yrityksissä voi olla käytössään useita eri järjestelmiä. Nykyään on myös mahdollista, että tietojärjestelmät räätälöidään yrityskohtaisesti niiden omien tarpeiden mukaan. Kohdeyrityksestä saatujen vuosien 2007-2010 tilinpäätöstietojen avulla rakennettiin tiedosto Visma Navita Yritysmalliin ja laadittiin ennusteet kolmelle seuraavalle toimintakaudelle. Haastatteluista saatujen tietojen perusteella ennusteet laadittiin Diacor terveyspalvelut Oy:n talousjohdon valitsemilla tekijöillä sekä keskityttiin niiden tunnuslukujen arviointiin ja kuvaamiseen, jotka parhaiten havainnollistavat yrityksen tilannetta ja tulevaisuutta. Lisäksi ohjelmistolla laadittiin ennuste investoinnin vaikutuksesta ja mitä jos -analyysi muiden tekijöiden vaikutuksesta yrityksen tulokseen, näiden ennusteiden osalta luvut olivat fiktiivisiä. Työssä tuotettiin Diacor terveyspalvelut Oy:lle malliraportit ennusteiden laatimisesta Visma Navita Yritysmalli -ohjelmiston tarjoamilla vakioraporteilla ja omilla raporttiehdotuksilla sekä työhön liitettiin käytännön ohjeet helpottamaan ohjelmiston käyttöä tulevaisuudessa. Tutkimuksen perusteella Visma Navita Yritysmalli nähdään hyödylliseksi työkaluksi Diacorin talousjohdon käyttöön. Ohjelma on käytettävyydeltään haastava ja osaltaan tämän vuoksi jäänyt Diacorilla vähälle käytölle. Kuitenkin ohjelma voi helpottaa talousjohdon raportointia ja taloudellisten ennusteiden laadintaa yritysjohdolle. Näin ollen pikaohjeen luominen ohjelmaa pääosin käyttävälle henkilölle koettiin hyödylliseksi.Creating financial forecasts with Visma Navita Yritysmalli in Diacor terveyspalvelut Oy The purpose of this thesis was to find out how analysis and forecast software Visma Navita Yritysmalli supports the management of the target company’s decision making and identify any potential areas of development. The target company of this thesis is Diacor terveyspalvelut Oy which is a company which operates in the metropolitan area and produces private health services. The theoretical part of this thesis consist of service business, financial control and information systems. Service business theory can be used to understand the target company's operations and provide some perspective on the company's financial structure. In order to understand the significance of the financial management of corporate decision-making process, this thesis goes through all aspects of financial management and how in theory it can assist the company’s operations. There are numerous information systems, and in many companies several different systems may be used at the same time. Nowadays it is possible that information systems are been tailored according to company’s own needs. With the information of financial statements of the years 2007-2010 which have been received from the target company a file was built in Visma Navita Yritysmalli and forecasts were compiled for the next three operational periods. With the information that was received from interviews were made forecasts with criteria’s chosen by financial management of Diacor terveyspalvelut Oy. This thesis is focused on evaluating and describing those key indicators that describe the situation and the future of this target company. In this thesis forecasts were made to see the effect of investments on the profit of the company. The effect of other indicators on the company’s financial result was demonstrated with what if –analysis. The numbers in this forecast were fictional. Model reports were created with standard reports that Visma Navita Yritysmalli –software is offering. Own suggestion of reports were also made and the practical instructions are attached to the work to facilitate the use of the software in the future The result of this thesis was that Visma Navita Yritysmalli is being seen as a useful tool to be used in financial management of Diacor. Software is operationally challenging, and therefore it has not been used much lately in Diacor. The software may after all facilitate the financial management reporting and making financial forecasts to the company's management. Practical instructions to the person using the program were felt to be useful

NOT ALONE: DOING FIELDWORK IN THE COMPANY OF FAMILY MEMBERS

Reflecting on three case studies, this article provides an empirically grounded discussion of the challenges and opportunities that arise from doing fieldwork in the company of one’s children and spouse. The article highlights that during fieldwork, one’s private and professional lives are intermingled and the knowledge that one gains is always situated in particular ways. In this article, three female anthropologists elaborate on how they juggle multiple identity positions during fieldwork and how those negotiations and the presence and actions of accompanying family members affect the research material. Children and spouses may be useful during fieldwork but they may also disturb it or take it in unexpected directions. Acknowledging that fieldwork is part of life and that our everyday lives affect the fieldwork process is not a positive or negative thing per se; it is a part of the dynamics that can produce fruitful moments of serendipity

Data-driven multivariate population subgrouping via lipoprotein phenotypes versus apolipoprotein B in the risk assessment of coronary heart disease

Background and aims: Population subgrouping has been suggested as means to improve coronary heart disease (CHD) risk assessment. We explored here how unsupervised data-driven metabolic subgrouping, based on comprehensive lipoprotein subclass data, would work in large-scale population cohorts. Methods: We applied a self-organizing map (SOM) artificial intelligence methodology to define subgroups based on detailed lipoprotein profiles in a population-based cohort (n = 5789) and utilised the trained SOM in an independent cohort (n = 7607). We identified four SOM-based subgroups of individuals with distinct lipoprotein profiles and CHD risk and compared those to univariate subgrouping by apolipoprotein B quartiles. Results: The SOM-based subgroup with highest concentrations for non-HDL measures had the highest, and the subgroup with lowest concentrations, the lowest risk for CHD. However, apolipoprotein B quartiles produced better resolution of risk than the SOM-based subgroups and also striking dose-response behaviour. Conclusions: These results suggest that the majority of lipoprotein-mediated CHD risk is explained by apolipoprotein B-containing lipoprotein particles. Therefore, even advanced multivariate subgrouping, with comprehensive data on lipoprotein metabolism, may not advance CHD risk assessmentPeer reviewe

Pilot Study: Comparison of Sourdough Wheat Bread and Yeast-Fermented Wheat Bread in Individuals with Wheat Sensitivity and Irritable Bowel Syndrome

Many patients suspect wheat as being a major trigger of their irritable bowel syndrome (IBS) symptoms. Our aim was to evaluate whether sourdough wheat bread baked without baking improvers and using a long dough fermentation time (>12 h), would result in lower quantities of alpha-amylase/trypsin inhibitors (ATIs) and Fermentable, Oligo-, Di-, Mono-saccharides and Polyols (FODMAPs), and would be better tolerated than yeast-fermented wheat bread for subjects with IBS who have a poor subjective tolerance to wheat. The study was conducted as a randomised double-blind controlled 7-day study (n = 26). Tetrameric ATI structures were unravelled in both breads vs. baking flour, but the overall reduction in ATIs to their monomeric form was higher in the sourdough bread group. Sourdough bread was also lower in FODMAPs. However, no significant differences in gastrointestinal symptoms and markers of low-grade inflammation were found between the study breads. There were significantly more feelings of tiredness, joint symptoms, and decreased alertness when the participants ate the sourdough bread (p ≤ 0.03), but these results should be interpreted with caution. Our novel finding was that sourdough baking reduces the quantities of both ATIs and FODMAPs found in wheat. Nonetheless, the sourdough bread was not tolerated better than the yeast-fermented bread.Peer reviewe

A novel Bayesian approach to quantify clinical variables and to determine their spectroscopic counterparts in 1H NMR metabonomic data

<p>Abstract</p> <p>Background</p> <p>A key challenge in metabonomics is to uncover quantitative associations between multidimensional spectroscopic data and biochemical measures used for disease risk assessment and diagnostics. Here we focus on clinically relevant estimation of lipoprotein lipids by ¹H NMR spectroscopy of serum.</p> <p>Results</p> <p>A Bayesian methodology, with a biochemical motivation, is presented for a real ¹H NMR metabonomics data set of 75 serum samples. Lipoprotein lipid concentrations were independently obtained for these samples via ultracentrifugation and specific biochemical assays. The Bayesian models were constructed by Markov chain Monte Carlo (MCMC) and they showed remarkably good quantitative performance, the predictive R-values being 0.985 for the very low density lipoprotein triglycerides (VLDL-TG), 0.787 for the intermediate, 0.943 for the low, and 0.933 for the high density lipoprotein cholesterol (IDL-C, LDL-C and HDL-C, respectively). The modelling produced a kernel-based reformulation of the data, the parameters of which coincided with the well-known biochemical characteristics of the ¹H NMR spectra; particularly for VLDL-TG and HDL-C the Bayesian methodology was able to clearly identify the most characteristic resonances within the heavily overlapping information in the spectra. For IDL-C and LDL-C the resulting model kernels were more complex than those for VLDL-TG and HDL-C, probably reflecting the severe overlap of the IDL and LDL resonances in the ¹H NMR spectra.</p> <p>Conclusion</p> <p>The systematic use of Bayesian MCMC analysis is computationally demanding. Nevertheless, the combination of high-quality quantification and the biochemical rationale of the resulting models is expected to be useful in the field of metabonomics.</p

Abdominal obesity and circulating metabolites : A twin study approach

Objective. To investigate how obesity, insulin resistance and low-grade inflammation link to circulating metabolites, and whether the connections are due to genetic or environmental factors. Subjects and methods. Circulating serum metabolites were determined by proton NMR spectroscopy. Data from 1368 (531 monozygotic (MZ) and 837 dizygotic (DZ)) twins were used for bivariate twin modeling to derive the genetic (r(g)) and environmental (re) correlations between waist circumference (WC) and serum metabolites. Detailed examination of the associations between fat distribution (DEXA) and metabolic health (HOMA-IR, CRP) was performed among 286 twins including 33 BMI-discordant MZ pairs (intrapair BMI difference >= 3 kg/m(2)). Results. Fat, especially in the abdominal area (i.e. WC, android fat % and android to gynoid fat ratio), together with HOMA-IR and CRP correlated significantly with an atherogenic lipoprotein profile, higher levels of branched-chain (BCAA) and aromatic amino acids, higher levels of glycoprotein, and a more saturated fatty acid profile. In contrast, a higher proportion of gynoid to total fat associated with a favorable metabolite profile. There was a significant genetic overlap between WC and several metabolites, most strongly with phenylalanine (r(g) = 0.40), glycoprotein (r(g) = 0.37), serum triglycerides (r(g) = 0.36), BCAAs (r(g) = 0.30-0.40), HDL particle diameter (r(g) = -0.33) and HDL cholesterol (r(g) = -0.30). The effect of acquired obesity within the discordant MZ pairs was particularly strong for atherogenic lipoproteins. Conclusions. A wide range of unfavorable alterations in the serum metabolome was associated with abdominal obesity, insulin resistance and low-grade inflammation. Twin modeling and obesity-discordant twin analysis suggest that these associations are partly explained by shared genes but also reflect mechanisms independent of genetic liability. (C) 2015 Elsevier Inc. All rights reserved.Peer reviewe

Genetic and observational evidence : No independent role for cholesterol efflux over static high-density lipoprotein concentration measures in coronary heart disease risk assessment

Background Observational findings for high-density lipoprotein (HDL)-mediated cholesterol efflux capacity (HDL-CEC) and coronary heart disease (CHD) appear inconsistent, and knowledge of the genetic architecture of HDL-CEC is limited. Objectives A large-scale observational study on the associations of HDL-CEC and other HDL-related measures with CHD and the largest genome-wide association study (GWAS) of HDL-CEC. Participants/methods Six independent cohorts were included with follow-up data for 14,438 participants to investigate the associations of HDL-related measures with incident CHD (1,570 events). The GWAS of HDL-CEC was carried out in 20,372 participants. Results HDL-CEC did not associate with CHD when adjusted for traditional risk factors and HDL cholesterol (HDL-C). In contradiction, almost all HDL-related concentration measures associated consistently with CHD after corresponding adjustments. There were no genetic loci associated with HDL-CEC independent of HDL-C and triglycerides. Conclusion HDL-CEC is not unequivocally associated with CHD in contrast to HDL-C, apolipoprotein A-I, and most of the HDL subclass particle concentrations.Peer reviewe

Toward Xeno-Free Differentiation of Human Induced Pluripotent Stem Cell-Derived Small Intestinal Epithelial Cells

The small intestinal epithelium has an important role in nutrition, but also in drug absorption and metabolism. There are a few two-dimensional (2D) patient-derived induced pluripotent stem cell (iPSC)-based intestinal models enabling easy evaluation of transcellular transport. It is known that animal-derived components induce variation in the experimental outcomes. Therefore, we aimed to refine the differentiation protocol by using animal-free components. More specifically, we compared maturation of 2D-cultured iPCSs toward small intestinal epithelial cells when cultured either with or without serum, and either on Geltrex or on animal-free, recombinant laminin-based substrata. Differentiation status was characterized by qPCR, immunofluorescence imaging, and functionality assays. Our data suggest that differentiation toward definitive endoderm is more efficient without serum. Both collagen-and recombinant laminin-based coating supported differentiation of definitive endoderm, posterior definitive endoderm, and small intestinal epithelial cells from iPS-cells equally well. Small intestinal epithelial cells differentiated on recombinant laminin exhibited slightly more enterocyte specific cellular functionality than cells differentiated on Geltrex. Our data suggest that functional small intestinal epithelial cells can be generated from iPSCs in serum-free method on xeno-free substrata. This method is easily converted to an entirely xeno-free method.publishedVersionPeer reviewe

Direct Estimation of HDL-Mediated Cholesterol Efflux Capacity from Serum

BACKGROUND: HDL-mediated cholesterol efflux capacity (HDL-CEC) is a functional attribute that may have a protective role in atherogenesis. However, the estimation of HDL-CEC is based on in vitro cell assays that are laborious and hamper large-scale phenotyping. METHODS: Here, we present a cost-effective high-throughput nuclear magnetic resonance (NMR) spectroscopy method to estimate HDL-CEC directly from serum. We applied the new method in a population-based study of 7603 individuals including 574 who developed incident coronary heart disease (CHD) during 15 years of follow-up, making this the largest quantitative study for HDL-CEC. RESULTS: As estimated by NMR-spectroscopy, a 1-SD higher HDL-CEC was associated with a lower risk of incident CHD (hazards ratio, 0.86; 95% CI, 0.79-0.93, adjusted for traditional risk factors and HDL-C). These findings are consistent with published associations based on in vitro cell assays. CONCLUSIONS: These corroborative large-scale findings provide further support for a potential protective role of HDL-CEC in CHD and substantiate this new method and its future applications. (C) 2019 American Association for Clinical ChemistryPeer reviewe

Characterization of metabolic interrelationships and in silico phenotyping of lipoprotein particles using self-organizing maps

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