Medicines information sources and services for consumers : A special focus on the Internet and people with depression

The range of consumer health and medicines information sources has diversified along with the increased use of the Internet. This has led to a drive to develop medicines information services and to better incorporate the Internet and e-mail into routine practice in health care and in community pharmacies. To support the development of such services more information is needed about the use of online information by consumers, particularly of those who may be the most likely to use and to benefit from the new sources and modes of medicines communication. This study explored the role and utilization of the Internet-based medicines information and information services in the context of a wider network of information sources accessible to the public in Finland. The overall aim was to gather information to develop better and more accessible sources of information for consumers and services to better meet the needs of consumers. Special focus was on the needs and information behavior among people with depression and using antidepressant medicines. This study applied both qualitative and quantitative methods. Consumer medicines information needs and sources were identified by analyzing the utilization of the University Pharmacy operated national drug information call center (Study I) and surveying Finnish adults (n=2348) use of the different medicines information sources (Study II). The utilization of the Internet as a source of antidepressant information among people with depression was explored by focus group discussions among people with depression and with current or past use of the antidepressant(s) (n=29, Studies III & IV). Pharmacy response to the needs of consumers in term of providing e-mail counseling was assessed by conducting a virtual pseudo customer study among the Finnish community pharmacies (n=161, Study V). Physicians and pharmacists were the primary sources of medicines information. People with mental disorders were more frequent users of telephone- and Internet-based medicines information sources and patient information leaflets than people without mental disorders. These sources were used to complement rather than replace information provided face-to-face by health professionals. People with depression used the Internet to seek facts about antidepressants, to share experiences with peers, and for the curiosity. They described that the access to online drug information was empowering. Some people reported lacking the skills necessary to assess the quality of online information. E-mail medication counseling services provided by community pharmacies were rare and varied in quality. Study results suggest that rather than discouraging the use of the Internet, health professionals should direct patients to use accurate and reliable sources of online medicines information. Health care providers, including community pharmacies should also seek to develop new ways of communicating information about medicines with consumers. This study determined that people with depression and using antidepressants need services enabling interactive communication not only with health care professionals, but also with peers. Further research should be focused on developing medicines information service facilitating communication among different patient and consumer groups.

Young people's perceptions of the wood products industry : a relational view

The basis for this study was in poor attractiveness of the wood products industry among young people as a field to study and work in. The purpose was to produce new information of how to improve the relationship between young people and the wood products industry in order to better attract young people with different relational orientation. A survey was conducted among students of comprehensive schools and students of wood industry at vocational schools selected by systematic cluster sampling. The final sample consisted of 613 students. The study combined the theories and concepts of relationships, communication and trust of several disciplines. In addition, it applied theories of relationship marketing, stakeholders, publics, involvement and concepts of reputation and values. It studied the central relational elements in the form of antecedents, relationship state and its consequences. The study examined, how young people with different background and level of interest perceive wood industry as a field to study and work in from relational point of view, what are the central deficiencies in perceived relational elements and what are the public relations activities enhancing the relationship between wood industry and young people with less and high interest in the sector. The results indicate poor visibility of the wood industry among young people: unfamiliarity with the industry and unawareness of the opportunities to study in the field. It appeared that instead of increasing only information sharing, interactive communication in different forms is needed. The study also suggests that behaviors of the industry sector advancing perceived trustworthiness are of crucial importance. Moreover, the wood industry needs to pay attention to its behaviors and communication also among other stakeholder groups, especially the media, as reputation plays an important role in building up trust and satisfaction between young people and the sector. Finally, the less and highly interested young people were found to assess the relationship partly through different relational elements. In order to develop the relationship with highly interested young people they should be regarded clearly as future employees of the wood industry through activities affirming that they are desired and valued employees in the sector. Further, openness of information disclosure, whether concerning current situation or future prospects, seems to increase credibility and attractiveness of the wood industry. Highly interested young people were also found to appreciate socially responsible activities. The less interested young people seem to be insecure about the reliability of the wood industry as an employer, as well as, its ability and interest to invest in young people s skills. In addition,involvement in issues relevant for young people was found crucial in enhancing the relationship with the less interested young people.The conclusions of the study provide tools for enhancing the attractiveness of the wood industry among young people not only to the industry itself, but also to its advocates, teachers and student counselors of comprehensive and vocational schools, authorities and policy makers.

The Nature of Learning about Customers in a Customer Service Setting - A Study of Frontline Contact Persons

The starting point of this thesis is the notion that in order for organisations to understand what customers value and how customers experience service, they need to learn about customers. The first and perhaps most important link in an organisation-wide learning process directed at customers is the frontline contact person. Service- and sales organisations can only learn about customers if the individual frontline contact persons learn about customers. Even though it is commonly recognised that learning about customers is the basis for an organisation’s success, few contributions within marketing investigate the fundamental nature of the phenomenon as it occurs in everyday customer service. Thus, what learning about customers is and how it takes place in a customer-service setting is an issue that is neglected in marketing research. In order to explore these questions, this thesis presents a socio-cultural approach to understanding learning about customers. Hence, instead of considering learning equal to cognitive processes in the mind of the frontline contact person or learning as equal to organisational information processing, the interactive, communication-based, socio-cultural aspect of learning about customers is brought to the fore. Consequently, the theoretical basis of the study can be found both in socio-cultural and practice-oriented lines of reasoning, as well as in the fields of service- and relationship marketing. As it is argued that learning about customers is an integrated part of everyday practices, it is also clear that it should be studied in a naturalistic and holistic way as it occurs in a customer-service setting. This calls for an ethnographic research approach, which involves direct, first-hand experience of the research setting during an extended period of time. Hence, the empirical study employs participant observations, informal discussions and interviews among car salespersons and service advisors at a car retailing company. Finally, as a synthesis of theoretically and empirically gained understanding, a set of concepts are developed and they are integrated into a socio-cultural model of learning about customers.

Esteettinen kokemus kulttuurisiltana : Soile Yli-Mäyryn taide kiinalaisen, japanilaisen ja suomalaisen yleisön kokemana

AESTHETIC EXPERIENCE AS A BRIDGE ACROSS CULTURES Soile Yli-Mäyry s art as experienced by Chinese, Japanese and Finnish audiences This study focuses on surveying and analysing experiences of Soile Yli-Mäyry s art in eleven different countries. Questionnaires were translated into nine different languages. In addition, interviews were conducted on the experiences of Chinese, Japanese and Finnish art audiences concerning a painting called Sun Wind . The study was mainly inspired by John Dewey s ideas of art as an interactive communication where the artist, the piece and those who experience it make up an interactive process. In this process experience is a meeting point with both individual and communal characteristics. The data was collected in conjunction with exhibitions in 1997−2005. The survey was carried out in eleven countries (Finland, United States, Brazil, China, Taiwan, Japan, India, Israel, Argentina, Germany and Switzerland). The survey data was made up of 2,563 returned questionnaires. The interviews in China, Japan and Finland were about the same painting Sun Wind , which was transported from Finland to Japan (Tokyo) and China. A total of 89 people were interviewed in Shanghai Art Museum, 30 people in Port-Ginza Gallery, Tokyo and 45 people in Soile Yli-Mäyry s Gallery in Finland. Three hypotheses that were turned into research questions directed the study: 1. Are there differences/ similarities between culturally different communities in the meanings attributed to experiences, e.g. according to emotional dimensions, or do experiences focus more on reflecting on one s own life or meanings attributed to the world around us? What kinds of experiential dimensions are there in different countries? Do similar, analogous experiences that transcend cultural barriers emerge in culturally different countries such as China, Japan and Finland? 2. Does the data display different types of experiencing subjects which are typical to a subject s own country or are they experiences that can be compared to those generated by an ideal landscape , where the art touches the subconscious and collective selfhood, being thus transnational and timeless? Closer analysis focuses on audience experiences in China, Japan and Finland (interviews, textual survey data). 3. Are the experiences and interpretations of experts similar/different to those of larger audiences? The survey data has been analysed with the help of cross-tabulation. After content analysis of the interviews and textual survey data, different ways of experiencing subjects were sketched by country (China, Japan, Finland). The types were both similar and dissimilar. The most important types were social/ecological (China), therapeutic/reserved (Japan) and narrative/projecting (Finland). There were differences in how experiences were emphasised: the Chinese public approached their experiences from the viewpoint of pragmatism and utility, where they could obtain new ideas for their own work or experiencing the exhibition gave courage to approach their own lives from a new perspective. In turn, the Japanese public experienced the art from a therapeutic angle and from a very reserved perspective, which Dylan Evans (2001, 13−17) has described as typical to Japanese culture. The experiences of the Finnish audience were strongly therapeutic and narrative. The people projected their emotions onto the piece and in a concrete manner forged them into a story. The partly similar results of this study in China, Japan and Finland demonstrate that the art displayed in the exhibitions contain images of the beginning or elements connected to the beginning of life, which touch the subconscious in the way an ideal landscape would. Experiencing the meaningfulness of one s own life through art is a common thread and a bridge across cultures that unites the experiences of the audiences of this study, be they Taoists, Confucians, Buddhists or Maoists in China, Shinto followers, Zen Buddhists in Japan or Evangelist-Lutherans in Finland. Keywords: experience, reception, bridge across cultures, types of experiencing subjects, experiential process, ideal landscape, elementality

Personality and social psychological studies on computer-mediated communication in school settings

The present study examined how personality and social psychological factors affect third and fourth graders' computer-mediated communication. Personality was analysed in terms of the following strategies: optimism, pessimism and defensive pessimism. Students worked either individually or in dyads which were paired homogeneously or heterogeneously according to the strategies. Moreover, the present study compared horizontal and vertical interaction. The study also examined the role that popularity plays, and students were divided into groups based on their popularity level. The results show that an optimistic strategy is useful. Optimism was found to be related to the active production and processing of ideas. Although previous research has identified drawbacks to pessimism in achievement settings, this study shows that the pessimistic strategy is not as debilitating a strategy as is usually assumed. Pessimistic students were able to process their ideas. However, defensive pessimists were somewhat cautious in introducing or changing ideas. Heterogeneous dyads were not beneficial configurations with respect to producing, introducing, or changing ideas. Moreover, many differences were found to exist between the horizontal and vertical interaction; specifically, the students expressed more opinions and feelings when teachers took no part in the discussions. Strong emotions were observed especially in the horizontal interaction. Further, group working skills were found to be more important for boys than for girls, while rejected students were not at a disadvantage compared to popular ones. Schools can encourage emotional and social learning. The present study shows that students can use computers to express their feelings. In addition, students who are unpopular in non-computer contexts or students who use pessimism can benefit from computers. Participation in computer discussions can give unpopular children a chance to develop confidence when relating to peers.

Keltaista ja kimaltavaa : kodin ja koulun yhteistyöstä koulun ja kodin yhteyteen

Through this study I aim to portray connections between home and school through the patterns of thought and action shared in everyday life in a certain community. My observations are primarily based upon interviews, writings and artwork by people from home (N=32) and school (N=13) contexts. Through the stories told, I depict the characters and characteristic features of the home-school interaction by generations. According to the material, in the school days of the grandparents the focus was on discipline and order. For the parents, the focus had shifted towards knowledge, while for the pupils today, the focus lies on evaluation, through which the upbringing of the child is steered towards favourable outcomes. Teachers and those people at home hold partially different understandings of home-school interaction, both of its manifested forms and potentials. The forms of contact in use today are largely seen as one-sided. Yearning for openness and regularity is shared by both sides, yet understood differently. Common causes for failure are said to lie in plain human difficulties in communication and social interaction, but deeply rooted traditions regarding forms of contact also cast a shadow on the route to successful co-operation. This study started around the idea, that home-school interaction should be steered towards the ex-change of constructive ideas between both the home and school environments. Combining the dif-ferent views gives to something to build upon. To test this idea, I drafted a practice period, which was implemented in a small pre-school environment in the fall of 1997. My focus of interest in this project was on the handling of ordinary life information in the schools. So I combined individual views, patterns of knowledge and understanding of the world into the process of teaching. Works of art and writings by the informants worked as tools for information processing and as practical forms of building home-school interaction. Experiences from the pre-school environ-ment were later on echoed in constructing home-school interaction in five other schools. In both these projects, the teaching in the school was based on stories, thoughts and performances put to-gether by the parents, grandparents and children at home. During these processes, the material used in this study, consisting of artwork, writings and interviews (N=501), was collected. The data shows that information originating from the home environments was both a motivating and interesting addition to the teaching. There even was a sense of pride when assessing the seeds of knowledge from one’s own roots. In most cases and subjects, the homegrown information content was seamlessly connected to the functions of school and the curriculum. This project initiated thought processes between pupils and teachers, adults, children and parents, teachers and parents, and also between generations. It appeared that many of the subjects covered had not been raised before between the various participant groups. I have a special interest here in visual expression and its various contextual meanings. There art material portrays how content matter and characteristic features of the adult and parent contexts reflect in the works of the children. Another clearly noticeable factor in the art material is the impact of time-related traditions and functions on the means of visual expression. Comparing the visual material to the written material reveals variances of meaning and possibilities between these forms of expression. The visual material appears to be related especially to portraying objects, action and usage. Processing through that making of images was noted to bring back memories of concrete structures, details and also emotions. This process offered the child an intensive social connection with the adults. In some cases, with children and adults alike, this project brought forth an ongoing relation to visual expression. During this study I end up changing the concept to ‘home-school collaboration’. This widely used concept guides and outlines the interaction between schools and homes. In order to broaden the field of possibilities, I choose to use the concept ‘school-home interconnection’. This concept forms better grounds for forming varying impressions and practices when building interactive contexts. This concept places the responsibility of bridging the connection-gap in the schools. Through the experiences and innovations of thought gained from these projects, I form a model of pedagogy that embraces the idea of school-home interconnection and builds on the various impres-sions and expressions contained in it. In this model, school makes use of the experiences, thoughts and conceptions from the home environment. Various forms of expression are used to portray and process this information. This joint evaluation and observation evolves thought patterns both in school and at home. Keywords: percieving, visuality, visual culture, art and text, visual expression, art education, growth in interaction, home-school collaboration, school-home interconnection, school-home interaction model.

On linear order and computation : The expressiveness of interactive computations on linear orders and computations indexed by ordinals

We solve the Dynamic Ehrenfeucht-Fra\"iss\'e Game on linear orders for both players, yielding a normal form for quantifier-rank equivalence classes of linear orders in first-order logic, infinitary logic, and generalized-infinitary logics with linearly ordered clocks. We show that Scott Sentences can be manipulated quickly, classified into local information, and consistency can be decided effectively in the length of the Scott Sentence. We describe a finite set of linked automata moving continuously on a linear order. Running them on ordinals, we compute the ordinal truth predicate and compute truth in the constructible universe of set-theory. Among the corollaries are a study of semi-models as efficient database of both model-theoretic and formulaic information, and a new proof of the atomicity of the Boolean algebra of sentences consistent with the theory of linear order -- i.e., that the finitely axiomatized theories of linear order are dense.

Ion-regulatory proreins in neuronal development and communication

Brain function is critically dependent on the ionic homeostasis in both the extra- and intracellular compartment. The regulation of brain extracellular ionic composition mainly relies on active transport at blood brain and at blood cerebrospinal fluid interfaces whereas intracellular ion regulation is based on plasmalemmal transporters of neurons and glia. In addition, the latter mechanisms can generate physiologically as well as pathophysiologically significant extracellular ion transients. In this work I have studied molecular mechanisms and development of ion regulation and how these factors alter neuronal excitability and affect synaptic and non-synaptic transmission with a particular emphasis on intracellular pH and chloride (Cl-) regulation. Why is the regulation of acid-base equivalents (H+ and HCO3-) and Cl- of such interest and importance? First of all, GABAA-receptors are permeable to both HCO3- and Cl-. In the adult mammalian central nervous system (CNS) fast postsynaptic inhibition relies on GABAA-receptor mediated transmission. Today, excitatory effects of GABAA-receptors, both in mature neurons and during the early development, have been recognized and the significance of the dual actions of GABA on neuronal communication has become an interesting field of research. The transmembrane gradients of Cl- and HCO3- determine the reversal potential of GABAA-receptor mediated postsynaptic potentials and hence, the function of pH and Cl- regulatory proteins have profound consequences on GABAergic signaling and neuronal excitability. Secondly, perturbations in pH can cause a variety of changes in cellular function, many of them resulting from the interaction of protons with ionizable side chains of proteins. pH-mediated alterations of protein conformation in e.g. ion channels, transporters, and enzymes can powerfully modulate neurotransmission. In the context of pH homeostasis, the enzyme carbonic anhydrase (CA) needs to be taken into account in parallel with ion transporters: for CO2/HCO3- buffering to act in a fast manner, CO2 (de)hydration must be catalyzed by this enzyme. The acid-base equivalents that serve as substrates in the CO2 dehydration-hydration reaction are also engaged in many carrier and channel mediated ion movements. In such processes, CA activity is in key position to modulate transmembrane solute fluxes and their consequences. The bicarbonate transporters (BTs; SLC4) and the electroneutral cation-chloride cotransporters (CCCs; SLC12) belong the to large gene family of solute carriers (SLCs). In my work I have studied the physiological roles of the K+-Cl- cotransporter KCC2 (Slc12a5) and the Na+-driven Cl--HCO3- exchanger NCBE (Slc4a10) and the roles of these two ion transporters in the modualtion of neuronal communication and excitability in the rodent hippocampus. I have also examined the cellular localization and molecular basis of intracellular CA that has been shown to be essential for the generation of prolonged GABAergic excitation in the mature hippocampus. The results in my Thesis provide direct evidence for the view that the postnatal up-regulation of KCC2 accounts for the developmental shift from depolarizing to hyperpolarizing postsynaptic EGABA-A responses in rat hippocampal pyramidal neurons. The results also indicate that after KCC2 expression the developmental onset of excitatory GABAergic transmission upon intense GABAA-receptor stimulation depend on the expression of intrapyramidal CA, identified as the CA isoform VII. Studies on mice with targeted Slc4a10 gene disruption revealed an important role for NCBE in neuronal pH regulation and in pH-dependent modulation of neuronal excitability. Furthermore, this ion transporter is involved in the basolateral Na+ and HCO3- uptake in choroid plexus epithelial cells, and is thus likely to contribute to cerebrospinal fluid production.

Relationships in food chains: an empirical examination of trust, commitment and communication

This report derives from the EU funded research project “Key Factors Influencing Economic Relationships and Communication in European Food Chains” (FOODCOMM). The research consortium consisted of the following organisations: University of Bonn (UNI BONN), Department of Agricultural and Food Marketing Research (overall project co-ordination); Institute of Agricultural Development in Central and Eastern Europe (IAMO), Department for Agricultural Markets, Marketing and World Agricultural Trade, Halle (Saale), Germany; University of Helsinki, Ruralia Institute Seinäjoki Unit, Finland; Scottish Agricultural College (SAC), Food Marketing Research Team - Land Economy Research Group, Edinburgh and Aberdeen; Ashtown Food Research Centre (AFRC), Teagasc, Food Marketing Unit, Dublin; Institute of Agricultural & Food Economics (IAFE), Department of Market Analysis and Food Processing, Warsaw and Government of Aragon, Center for Agro-Food Research and Technology (CITA), Zaragoza, Spain. The aim of the FOODCOMM project was to examine the role (prevalence, necessity and significance) of economic relationships in selected European food chains and to identify the economic, social and cultural factors which influence co-ordination within these chains. The research project considered meat and cereal commodities in six different European countries (Finland, Germany, Ireland, Poland, Spain, UK/Scotland) and was commissioned against a background of changing European food markets. The research project as a whole consisted of seven different work packages. This report presents the results of qualitative research conducted for work package 5 (WP5) in the pig meat and rye bread chains in Finland. Ruralia Institute would like to give special thanks for all the individuals and companies that kindly gave up their time to take part in the study. Their input has been invaluable to the project. The contribution of research assistant Sanna-Helena Rantala was significant in the data gathering. FOODCOMM project was coordinated by the University of Bonn, Department of Agricultural and Food Market Research. Special thanks especially to Professor Monika Hartmann for acting as the project leader of FOODCOMM.

Key Factors Influencing Economic Relationships and Communication in Finnish Food Chains

The aim of this report is to discuss the role of the relationship type and communication in two Finnish food chains, namely the pig meat-to-sausage (pig meat chain) and the cereal-to-rye bread (rye chain) chains. Furthermore, the objective is to examine those factors influencing the choice of a relationship type and the sustainability of a business relationship. Altogether 1808 questionnaires were sent to producers, processors and retailers operating in these two chains of which 224 usable questionnaires were returned (the response rate being 12.4%). The great majority of the respondents (98.7%) were small businesses employing less than 50 people. Almost 70 per cent of the respondents were farmers. In both chains, formal contracts were stated to be the most important relationship type used with business partners. Although for many businesses written contracts are a common business practice, the essential role of the contracts was the security they provide regarding the demand/supply and quality issues. Relative to the choice of the relationship types, the main difference between the two chains emerged especially with the prevalence of spot markets and financial participation arrangements. The usage of spot markets was significantly more common in the rye chain when compared to the pig meat chain, while, on the other hand, financial participation arrangements were much more common among the businesses in the pig meat chain than in the rye chain. Furthermore, the analysis showed that most of the businesses in the pig meat chain claimed not to be free to choose the relationship type they use. Especially membership in a co-operative and practices of a business partner were mentioned as the reasons limiting this freedom of choice. The main business relations in both chains were described as having a long-term orientation and being based on formal written contracts. Typical for the main business relationships was also that they are not based on the existence of the key persons only; the relationship would remain even if the key people left the business. The quality of these relationships was satisfactory in both chains and across all the stakeholder groups, though the downstream processors and the retailers had a slightly more positive view on their main business partners than the farmers and the upstream processors. The businesses operating in the pig meat chain seemed also to be more dependent on their main business relations when compared to the businesses in the rye chain. Although the communication means were rather similar in both chains (the phone being the most important), there was some variation between the chains concerning the communication frequency necessary to maintain the relationship with the main business partner. In short, the businesses in the pig meat chain seemed to appreciate more frequent communication with their main business partners when compared to the businesses in the rye chain. Personal meetings with the main business partners were quite rare in both chains. All the respondent groups were, however, fairly satisfied with the communication frequency and information quality between them and the main business partner. The business cultures could be argued to be rather hegemonic among the businesses both in the pig meat and rye chains. Avoidance of uncertainty, appreciation of long-term orientation and independence were considered important factors in the business cultures. Furthermore, trust, commitment and satisfaction in business partners were thought to be essential elements of business operations in all the respondent groups. In order to investigate which factors have an effect on the choice of a relationship type, several hypotheses were tested by using binary and multinomial logit analyses. According to these analyses it could be argued that avoidance of uncertainty and risk has a certain effect on the relationship type chosen, i.e. the willingness to avoid uncertainty increases the probability to choose stable relationships, like repeated market transactions and formal written contracts, but not necessary those, which require high financial commitment (like financial participation arrangements). The probability of engaging in financial participation arrangements seemed to increase with long-term orientation. The hypotheses concerning the sustainability of the economic relations were tested by using structural equation model (SEM). In the model, five variables were found to have a positive and statistically significant impact on the sustainable economic relationship construct. Ordered relative to their importance, those factors are: (i) communication quality, (ii) personal bonds, (iii) equal power distribution, (iv) local embeddedness and (v) competition.

Boost Customer Loyalty with Online Support. The Case of Mobile Telecoms Providers.

The paper explores the effect of customer satisfaction with online supporting services on loyalty to providers of an offline core service. Supporting services are provided to customers before, during, or after the purchase of a tangible or intangible core product, and have the purpose of enhancing or facilitating the use of this product. The internet has the potential to dominate all other marketing channels when it comes to the interactive and personalised communication that is considered quintessential for supporting services. Our study shows that the quality of online supporting services powerfully affects satisfaction with the provider and customer loyalty through its effect on online value and enjoyment. Managerial implications are provided.