163 research outputs found

    Strategiaan osallistaminen ja vuorovaikutteinen jatkuvuus : case Huittisten, Kalannin ja Liedon Säästöpankit

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    Opinnäytetyön tavoitteena oli selvittää, miten nykyinen strategia ohjaa arkea Huittisten, Kalannin ja Liedon Säästöpankeissa sekä miten henkilöstö voisi osallistua strategiaan tulevaisuudessa nykyistä paremmin. Tutkijat valitsivat aiheen, koska aiemmat tutkimukset ovat olleet lähinnä strategian laatimiseen tai jalkauttamiseen liittyviä, joissa ei ole käsitelty henkilöstön osallistamista strategiaprosessiin. Tutkimuksen teoriapohjana on strategiaan, vuorovaikutukseen ja osallistamiseen liittyvä teoria. Tutkimuksen asiaongelmaksi muodostui hypoteesi: Strategia ei ohjaa arkea Säästöpankeissa. Asiaongelman pohjalta muodostui kolme tutkimuskysymystä: Mitkä ovat henkilöstön kokemukset strategian ohjaavuuden nykymallista? Mitkä ovat henkilöstön näkemykset toimivammasta mallista? Miten elävä, jatkuva ja vuorovaikutteinen strategia varmistetaan? Tutkimusmenetelmiksi valittiin kyselytutkimus, haastattelututkimus sekä triangulaatio. Henkilöstöt kokivat strategian jonkin verran ohjaavaksi tekijäksi päivittäisen työnsä kannalta. Strategiaan vaikuttaminen koettiin tutkimushetkellä vaikeaksi tai melko vaikeaksi. Vaikuttamistapojen osalta hyviksi koettiin koko henkilöstön pienryhmissä osallistavat tilaisuudet, joita järjestetään 1-2 kertaa vuodessa. Strategiasta täytyy lisäksi puhua jatkuvasti yksiköissä, jotta ymmärretään, minkä vuoksi yrityksessä toimitaan tietyllä tavalla tietyissä tilanteissa. Myös yrityksen aloitetoiminnan täytyy olla helppoa, aloitteen tekemisestä täytyy saada palautetta ja siitä voidaan tarvittaessa palkita. Yrityksen organisaatiokulttuurilla huomattiin olevan merkittävä rooli siihen, halutaanko palautetta antaa nimettömänä vai omaa nimeään käyttäen. Tällä puolestaan on suuri merkitys siihen henkilöstön halukkuuteen liiketoiminnan kehittäjänä. Tutkimuksen tuloksena laadittiin strategiaan osallistamisen malli, jota voidaan käyttää hyödyksi yrityksissä. Strategiaan osallistamisen mallin hyväksikäyttäminen organisaatioissa jatkuu tämän tutkimuksen jälkeen.The aim of this research was to examine how the current strategy guides the daily life of Huittinen, Kalanti and Lieto Savings banks, as well as how staff could be involved in strategy better in the future. The researchers chose the topic because previous studies have been mainly focused in the preparation or implementation of strategy, where studies have not been treated personnel involvement as a resource in a strategy process. The research’s theoretical basis is strategy, interaction and involving-related theory. The issue problem of research was formed of hypothesis: The strategy does not guide the everyday life in savings a bank. Based on the issue problem three research questions were formed: What are the personnel’s experiences of strategy’s guiding now? What are the personnel’s visions of a better working model? How can living, continuous and interactive strategy be ensured in the future? A survey, interviews and triangulation were chosen as research methods. The employees experienced strategy as somewhat a guiding factor in their daily work. Influencing in strategy was experienced hard or quite hard at the time of research. When employees were asked of influencing methods, 1-2 a year organized whole personnel involving events in small groups were felt to be in favor. The strategy must also be discussed constantly in units, in order to understand why you must operate certainly in certain situations in the company. Also the company initiative action must be easy to use, people must get feedback from their initiatives and possibly get rewarded for good initiatives. The company's organizational culture was found to play a significant role in whether employees want to give feedback anonymously or using their own names. This, in turn, has a great impact on how the employees want to develop business. As a result of this research was formed involving in a strategy model, which can be used for the benefit of companies. Benefiting from involving in the strategy model will continue in organizations after this research

    Mitä on sikiölääketiede?

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    Analyysia Steve Jordanin rumpujensoitosta shuffle-tyylisissä kappaleissa

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    Tämä opinnäytetyö käsittelee rumpalia nimeltä Steve Jordan ja erityisesti hänen rumpujensoittoaan shuffle-tyylisissä kappaleissa. Steve Jordan on yksi maailman työllistetyimmistä ja arvostetuimmista muusikoista. Opinnäytetyön tarkoituksena on ollut selvittää Jordanin musiikillisia ja soundillisia ratkaisuja kolmessa erilaisessa shuffle-tyylisessä musiikkikappaleessa. Kappaleita analysoitaessa tehtiin huomioita Steve Jordanin monipuolisesta ja avarasta suhtautumisesta musiikkiin. Kappaleet löytyvät kolmelta eri levyltä ja levyt on äänitetty eri vuosikymmeninä. Kappaleiden äänitysten eri ajankohdat ja kokoonpanojen erot huomioitiin analyysia tehdessä. Jordanin käyttämien eri laitteistojen vaikutukset ovat myös olleet tutkimuksen kohteena. Tutkimuskysymykset ovat: (1) Kuka on Steve Jordan? (2) Minkälaisia komppeja Jordan soittaa analysoitavaksi valituilla kappaleilla? (3) Minkälaisia soundeja Jordan on käyttänyt kappaleiden toteutuksissa? (4) Kuinka Jordan on kehittynyt uransa aikana? (5) Kuinka Jordanin soitto on vaikuttanut minuun muusikkona ja rumpalina? Kappaleita kuunneltiin tarkasti ja kuulokuvasta tehtiin nuotinnokset. Ne helpottavat lukijaa ymmärtämään opinnäytetyötä paremmin. Apuna tutkimuksessa käytettiin rumpualan lehtiä lukien haastatteluita Jordanista. Internetistä löytyvät videot Jordanin soitosta ovat syventäneet opinnäytetyön tuloksia ja Pohdinta-osiota. Jordan toimii rumpujensoiton ohella myös musiikintuottajana. Tuottajana toimiminen on selvästi vaikuttanut Jordanin soittoon paljon. Myös Jordanin multi-instrumentalismin vaikutus hänen soittoonsa on ollut hyvin suuri. Opinnäytetyössä tehtiin havaintoja ja päätelmiä Jordanin musiikillisesta kehityksestä. Tärkeä asia opinnäytetyössä on Jordanin vaikutus minun musiikilliseen kasvuuni. Koska Jordan on monipuolinen ja lahjakas muusikko, olen seurannut hänen uraansa jo vuosien ajan. Pohdin hänen vaikutusta minuun opinnäytetyön Pohdinta-osiossa.The goal of my thesis was to analyse shuffle grooves which were played by Steve Jordan. I investigated three different shuffles from three different bands. The tunes that I analysed range from 1970's to 2008. The main goal was to find out how Jordan played the grooves, how he varied his comping in different bands and why Jordan sounds unique. The methods I used in this thesis were: listened to the tunes, transcribed the drumparts into notes, analysed the transcriptions and made conclusions of them. Within the recordings Jordan's drumgear has obviously evolved and changed and that has also been under surveillance. The important survey questions were: 1) Who is Steve Jordan? 2) What kind of grooves he plays in the songs? 3) What kind of drumsounds he uses or produces in the songs? 4) How has he evolved during his career? 5) What has been the impact of Jordan on me and my playing? The tunes that were analysed were listened very carefully and the drum grooves were transcribed into notes. The tunes can be listened from the cd that is as an attachment. Drum magazines were read and live footage videos from Youtube have also widened my view on the subject. Through my thesis I have learnt much about Steve Jordan. One of the most important things in this study is Steve Jordan's impact on me and to my musical growth. I'll explain that in the last section of my thesis. In the last section I also enlighten my opinions towards music and drum playing

    Instructors’ views on the developmental needs of peer tutoring in the non-formal learning environment

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    There is a need to organize non-formal learning activities in mathematics for children and youth. In Finland, we are developing a new non-formal learning environment called Pulmaario where we use peer tutors as instructors. This study is the empirical problem analysis of the design-based research. The aim was to find out what kind of support the instructors of the Pulmaario learning environment felt they need. The research material (N=51) was collected with questionnaires. The analysis of the questionnaires was based on the method of inductive content analysis. The results shows the needs for developing the non-formal learning environment further.Non peer reviewe

    Fetal heart rate variability with hypoxemia in an instrumented sheep model

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    Abstract Objective We examined the effect of hypoxemia on fetal heart rate variability using the instrumented fetal sheep model. Methods In this prospective study, 19 pregnant sheep were instrumented under general anesthesia at a mean gestational age of 127 days. After a 5-day recovery, hypoxaemia was induced by attaching the mother to a re-breathing circuit. Hypoxemia was further extended till 120 minutes, following which it was reversed till matenal and fetal pO2 returned back to baseline. The heart rate recordings at baseline, hypoxemia of 30 and 120 minutes, and recovery were analysed to calculate short term variation (STV) in 16 epochs of 3.75sec each, every minute. Phase rectified signal averaging (window length L= 10, time T= 2 and Scale S=T) was used to calculate acceleration capacity (AC) and deceleration capacity (DC). Results At baseline, mean (SD) fetal pO2 was 2.90±0.38 kPa. Acute hypoxaemia was associated with a significant reduction in mean pO2 at 30 (1.60±0.37 kPa) and 120 (1.50±0.16 kPa) minutes. Mean (SD) fetal pO2 at recovery was 2.80±0.32 kPa. The median STV, AC and DC were 1.307 msec (IQR: 0.515 to 2.508), 1.295 (IQR: 0.990 to 2.685) BPM and 1.197 (IQR: 0.850 to 1.836) BPM respectively, at baseline. With 30-minute hypoxaemia, the values were 1.323 (IQR 0.753 to 2.744) msecs, 1.696 (IQR: 1.310 to 3.013) BPM & 1.584 (IQR 1.217 to 4.132) BPM. With 120-minute hypoxaemia, the values were 1.760 (IQR: 0.928 ? 4.656) msecs, 3.098 (IQR: 1.530 ? 5.163) BPM & 3.054 (IQR: 1.508 ? 4.522) BPM. At recovery they changed to 0.962 (IQR: 0.703 ? 1.154) msecs, 1.228 (IQR: 1.071 ? 2.234) BPM & 1.086 (IQR: 0.873 ? 1.568) BPM respectively. Hypoxemia for 30 and 120 minutes were associated with a significant increase in the DC compared to baseline (p = 0.014 & 0.017 respectively). The changes in STV and AC were not significant. Conclusion Acute hypoxaemia is associated with a significant increase in the deceleration capacity of the fetal heart rate. This article is protected by copyright. All rights reserved.Peer reviewe

    Varhainen sikiön kasvun hidastuminen - onko synnytykselle vaihtoehtoa?

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    Teema : sikiölääketiede. English summaryPeer reviewe

    Loss of skeletal muscle mass during neoadjuvant treatments correlates with worse prognosis in esophageal cancer : a retrospective cohort study

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    Background: Nutritional deficits, cachexia, and sarcopenia are extremely common in esophageal cancer. The aim of this article was to assess the effect of loss of skeletal muscle mass during neoadjuvant treatment on the prognosis of esophageal cancer patients. Methods: Esophageal cancer patients (N = 115) undergoing neoadjuvant therapy and surgery between 2010 and 2014 were identified from our surgery database and retrospectively analyzed. Computed tomography imaging of the total cross-sectional muscle tissue measured at the third lumbar level defined the skeletal muscle index, which defined sarcopenia (SMI <52.4 cm2/m2 for men and <38.5 cm2/m2 for women). Images were collected before and after neoadjuvant treatments. Results: Sarcopenia in preoperative imaging was prevalent in 92 patients (80%). Median overall survival was 900 days (interquartile range 334-1447) with no difference between sarcopenic (median = 900) and non-sarcopenic (median = 914) groups (p = 0.872). Complication rates did not differ (26.1% vs 32.6%, p = 0.725). A 2.98% decrease in skeletal muscle index during neoadjuvant treatment correlated with poor 2-year survival (log-rank p = 0.04). Conclusion: Loss of skeletal muscle tissue during neoadjuvant treatment correlates with worse overall survival.Peer reviewe

    Accuracy of fetal echocardiography diagnosis and anticipated perinatal and early postnatal care in congenital heart disease in mid-gestation

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    Introduction The aim of this study was to determine discrepancies in fetal congenital heart disease (CHD) diagnoses and anticipated early postnatal care and outcomes. Material and methods A retrospective review of 462 randomly selected cases (23% of all cases) referred to a fetal cardiac assessment during the second trimester (mean 26 weeks) at the Children's Hospital in Helsinki between October 2010 and December 2020. Discrepancy between prenatal and postnatal CHD case evaluations was assessed with independently provided cardiac severity and surgical complexity scores. Results In all, 250 cases, 181 CHD and 69 normal, with complete prenatal and postnatal live birth data as well as seven fetal autopsy reports available were included in the analysis. There were 12 false normal and seven false abnormal prenatal assessments. The prenatally anticipated level of early neonatal care was actualized in 62% and prostaglandin infusion in 95%. In total, 32.7% (84/257) cardiac severity scores were discrepant and in 12,4% (32/257) cases the discrepancies were considered significant (>= +/- 2 scores). Among significant discrepancies, CHD severity score was overestimated in 13 and underestimated in 19 in fetal assessment. Progression of CHD severity after mid-gestation and during early neonatal phase explained eight of 19 underestimated fetal assessments. The most common discrepant diagnostic categories included ventricular septal defects (n = 7), borderline ventricles (n = 7; 5 left heart, 1 right heart and 1 double outlet right ventricle/transposition of the great arteries), arch anomalies including coarctations (n = 5) and tricuspid valve dysplasias (n = 4) with a significant change in postnatal diagnoses and treatment. Conclusions Although fetal CHD diagnosis and counseling is accurate and reliable in general, the study elaborates specific areas of uncertainty in clinical fetal cardiology practice that may be important to consider in fetal CHD evaluation and counseling provided in mid-gestation.Peer reviewe

    Antenatal hemodynamic findings and heart rate variability in early school-age children born with fetal growth restriction

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    Background: According to epidemiological studies, impaired intrauterine growth increases the risk for cardiovascular morbidity and mortality in adulthood. Heart rate variability (HRV), which reflects the autonomic nervous system function, has been used for risk assessment in adults while its dysfunction has been linked to poor cardiovascular outcome. Objective: We hypothesized that children who were born with fetal growth restriction (FGR) and antenatal blood flow redistribution have decreased HRV at early school age compared to their gestational age matched peers with normal intrauterine growth. Study design: A prospectively collected cohort of children born with FGR (birth weight = -2SD. Conclusions: Early school age children born with FGR and intrauterine blood flow redistribution demonstrated altered heart rate variability. These prenatal and postnatal findings may be helpful in targeting preventive cardiovascular measures in FGR.Peer reviewe

    Fetal hemodynamics and language skills in primary school-aged children with fetal growth restriction : A longitudinal study

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    Aim: Long-term follow-up studies on children born with fetal growth restriction (FGR) have revealed a specific profile of neurocognitive difficulties, including problems with speech, language and literacy skills. We hypothesized that problems with communication skills, including language use and literacy skills of FGR children at primary school age are associated with prenatal circulatory changes. Methods: Ultrasonographic assessment of fetoplacental hemodynamics was performed prenatally in 77 fetuses. After a follow-up period of 8-10 years, assessment of reading and spelling skills using standardized tests and the Children's Communication Questionnaire (CCC-2) was performed to measure different language skills in 37 FGR children and 31 appropriately grown (AGA) controls, matched for gestational age. Results: Increased blood flow resistance in the umbilical artery (UA PI > 2 SD) during fetal life showed odds ratios of 3.5-19.1 for poor literacy and communication skills and need for speech and language therapy. Furthermore, FGR children with prenatal cerebral vasodilatation (cerebroplacental ratio (CPR) <-2 SD) had significantly poorer literacy and communication skills, at primary school age compared to the AGA controls. Abnormal CPR demonstrated odds ratios of 4.2-28.1 for poor literacy and communication skills and need for speech and language therapy. Conclusion: Increased blood flow resistance in the umbilical artery and cerebral vasodilatation are associated with poor communication, language, and literacy skills at early school age in children born with FGR. These findings indicate the need for continuous follow-up of this group and timely targeted support to ensure optimal academic outcomes.Peer reviewe
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