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.

Adjektiiveihin liittyvät kollokaatit kuntien Internet-sivujen esittelyteksteissä. Korpuslingvististen menetelmien mahdollisuudet ja rajat kvalitatiivisessa tutkimuksessa.

Tarkastelen kuntien esittelyteksteissä esiintyviä, adjektiiveihin ja adjektiiviryhmiin liittyviä kollokaatioita ja kolligaatioita, eli myötäilmauksia. Adjektiiveja käsittelen adjektiiviryhmittäin, joita on kuusi. Laskevassa kokojärjestyksessä aineistossani esiintyvät adjektiiviryhmät ovat seuraavat: suhteelliset, absoluuttiset, yksilöivät, taipumattomat, suhteutusadjektiivit sekä proadjektiivit. Kiinnitän huomiota erityisesti siihen, millaisia kollokaatiosuhteita (nousevat ja laskevat kollokaatiot) eri adjektiiveihin ja eri adjektiiviryhmiin liittyy. Käyttämäni tekstiaineisto on pienehkö sähköinen tekstikorpus, joka koostuu suomalaisten kuntien Internet-sivuilta kerätyistä esittelyteksteistä. Korpuksessa on yhteensä 119 tekstiä, ja niissä on kyse kunnan esittelystä Internet-sivustojen lukijoille, eli tavallisesti erilaisesta oman kunnan markkinoinnista. Aineistooni kuuluvien kuntien väkiluku on vähemmän kuin 3000 asukasta, eli tutkimuskunnissa kyse on kaikkein pienimmistä Suomen kunnista. Tutkimusaineistooni, eli sähköiseen korpukseen, kuuluvat tekstit on käsitelty Fintwol-ohjelmalla, jolloin niihin on tehty koneavusteinen morfologinen analyysi. Jokaiseen saneeseen on siis lisätty sille kuuluva morfologinen tulkinta. Tarkoitukseni onkin havainnoida myös tietokoneen mahdollistamia sähköisiä tutkimusmenetelmiä kvalitatiivisen kielentutkimuksen välineenä. Kollokaatioiden tutkimuksessa tekstikorpuksia on käytetty pitkään, mutta aiemmin morfologinen analyysi on tavallisesti tehty käsin ja analyysit perustuneet esimerkiksi tiettyjen lekseemien tarkasteluun. Tutkimuksessani selvitän, millaisia mahdollisuuksia tietokoneavusteinen analyysi tuo kvalitatiiviseen kielentutkimukseen sekä millaisia rajoituksia sillä on. Adjektiivi-kollokaatti-esiintymien avulla kuvaillaan esittelyteksteissä usein kuntaa joko suoraan tai välillisesti. Tietokoneavusteisesta analyysista saadut tulokset ovat lähinnä kvantitatiivisia, mutta käytän tarkastelun apuna konkordanssilistaa, eli niin kutsuttua KWIC-listaa (Key Word In Context), jonka tarkasteluvälin pituudeksi olen rajannut viisi sanaa. Tämä pituus sisältää tarkasteltavan lekseemin (adjektiivi) sekä kaksi sanaa sen edellä ja jäljessä. Havainnoin sähköisestä korpuksesta saamieni tilastollisten tulosten avulla myös sitä, millainen aineisto ja tekstilaji esittelytekstit ovat. Vertailen saamiani tuloksia muista korpuksista saatuihin tilastollisiin tuloksiin. Adjektiiviryhmiin liittyvät nousevat kollokaatiosuhteet, joissa kollokaatti on adjektiivia yleisempi, toistuvat läpi aineiston samanlaisina: Näissä kollokaatiosuhteissa adjektiivit kollokoivat useimmiten sellaisen sanaston kanssa, joka on varsin yleistä koko aineistossani. Esimerkiksi substantiivit kunta ja palvelu, jotka ovat koko aineiston yleisimpiä sanoja, esiintyvät kaikkien adjektiiviryhmien adjektiivien kollokaatteina toistuvasti. Ne myös ilmaisevat sellaisia esittelyteksteissä toistuvia aiheita, jotka ovat kunnille tärkeitä ja joita käsitellään monessa esittelytekstissä. Laskevat kollokaatiosuhteet taas ilmaisevat lähinnä esittelyteksteissä yleisiä, adjektiivien merkitystä määrittäviä leksikaalisia suhteita, kuten adjektiivi-kollokaatti-parit hyvät liikenneyhteydet tai kaunis maisema. Esittelytekstiaineistoni käsittelyyn tietokoneavusteinen analyysi soveltui vain osittain. Suurin ongelma aiheutui paikannimistä (esim.

Technical efficiency of blood component preparation in blood centres of 10 European countries

Various reasons, such as ethical issues in maintaining blood resources, growing costs, and strict requirements for safe blood, have increased the pressure for efficient use of resources in blood banking. The competence of blood establishments can be characterized by their ability to predict the volume of blood collection to be able to provide cellular blood components in a timely manner as dictated by hospital demand. The stochastically varying clinical need for platelets (PLTs) sets a specific challenge for balancing supply with requests. Labour has been proven a primary cost-driver and should be managed efficiently. International comparisons of blood banking could recognize inefficiencies and allow reallocation of resources. Seventeen blood centres from 10 countries in continental Europe, Great Britain, and Scandinavia participated in this study. The centres were national institutes (5), parts of the local Red Cross organisation (5), or integrated into university hospitals (7). This study focused on the departments of blood component preparation of the centres. The data were obtained retrospectively by computerized questionnaires completed via Internet for the years 2000-2002. The data were used in four original articles (numbered I through IV) that form the basis of this thesis. Non-parametric data envelopment analysis (DEA, II-IV) was applied to evaluate and compare the relative efficiency of blood component preparation. Several models were created using different input and output combinations. The focus of comparisons was on the technical efficiency (II-III) and the labour efficiency (I, IV). An empirical cost model was tested to evaluate the cost efficiency (IV). Purchasing power parities (PPP, IV) were used to adjust the costs of the working hours and to make the costs comparable among countries. The total annual number of whole blood (WB) collections varied from 8,880 to 290,352 in the centres (I). Significant variation was also observed in the annual volume of produced red blood cells (RBCs) and PLTs. The annual number of PLTs produced by any method varied from 2,788 to 104,622 units. In 2002, 73% of all PLTs were produced by the buffy coat (BC) method, 23% by aphaeresis and 4% by the platelet-rich plasma (PRP) method. The annual discard rate of PLTs varied from 3.9% to 31%. The mean discard rate (13%) remained in the same range throughout the study period and demonstrated similar levels and variation in 2003-2004 according to a specific follow-up question (14%, range 3.8%-24%). The annual PLT discard rates were, to some extent, associated with production volumes. The mean RBC discard rate was 4.5% (range 0.2%-7.7%). Technical efficiency showed marked variation (median 60%, range 41%-100%) among the centres (II). Compared to the efficient departments, the inefficient departments used excess labour resources (and probably) production equipment to produce RBCs and PLTs. Technical efficiency tended to be higher when the (theoretical) proportion of lost WB collections (total RBC+PLT loss) from all collections was low (III). The labour efficiency varied remarkably, from 25% to 100% (median 47%) when working hours were the only input (IV). Using the estimated total costs as the input (cost efficiency) revealed an even greater variation (13%-100%) and overall lower efficiency level compared to labour only as the input. In cost efficiency only, the savings potential (observed inefficiency) was more than 50% in 10 departments, whereas labour and cost savings potentials were both more than 50% in six departments. The association between department size and efficiency (scale efficiency) could not be verified statistically in the small sample. In conclusion, international evaluation of the technical efficiency in component preparation departments revealed remarkable variation. A suboptimal combination of manpower and production output levels was the major cause of inefficiency, and the efficiency did not directly relate to production volume. Evaluation of the reasons for discarding components may offer a novel approach to study efficiency. DEA was proven applicable in analyses including various factors as inputs and outputs. This study suggests that analytical models can be developed to serve as indicators of technical efficiency and promote improvements in the management of limited resources. The work also demonstrates the importance of integrating efficiency analysis into international comparisons of blood banking.

Multi-user resource-sharing problem for the Internet

In this thesis we study a series of multi-user resource-sharing problems for the Internet, which involve distribution of a common resource among participants of multi-user systems (servers or networks). We study concurrently accessible resources, which for end-users may be exclusively accessible or non-exclusively. For all kinds we suggest a separate algorithm or a modification of common reputation scheme. Every algorithm or method is studied from different perspectives: optimality of protocols, selfishness of end users, fairness of the protocol for end users. On the one hand the multifaceted analysis allows us to select the most suited protocols among a set of various available ones based on trade-offs of optima criteria. On the other hand, the future Internet predictions dictate new rules for the optimality we should take into account and new properties of the networks that cannot be neglected anymore. In this thesis we have studied new protocols for such resource-sharing problems as the backoff protocol, defense mechanisms against Denial-of-Service, fairness and confidentiality for users in overlay networks. For backoff protocol we present analysis of a general backoff scheme, where an optimization is applied to a general-view backoff function. It leads to an optimality condition for backoff protocols in both slot times and continuous time models. Additionally we present an extension for the backoff scheme in order to achieve fairness for the participants in an unfair environment, such as wireless signal strengths. Finally, for the backoff algorithm we suggest a reputation scheme that deals with misbehaving nodes. For the next problem -- denial-of-service attacks, we suggest two schemes that deal with the malicious behavior for two conditions: forged identities and unspoofed identities. For the first one we suggest a novel most-knocked-first-served algorithm, while for the latter we apply a reputation mechanism in order to restrict resource access for misbehaving nodes. Finally, we study the reputation scheme for the overlays and peer-to-peer networks, where resource is not placed on a common station, but spread across the network. The theoretical analysis suggests what behavior will be selected by the end station under such a reputation mechanism.

Architectural Solutions for Mobile RFID Services on Internet of Things

Mobile RFID services for the Internet of Things can be created by using RFID as an enabling technology in mobile devices. Humans, devices, and things are the content providers and users of these services. Mobile RFID services can be either provided on mobile devices as stand-alone services or combined with end-to-end systems. When different service solution scenarios are considered, there are more than one possible architectural solution in the network, mobile, and back-end server areas. Combining the solutions wisely by applying the software architecture and engineering principles, a combined solution can be formulated for certain application specific use cases. This thesis illustrates these ideas. It also shows how generally the solutions can be used in real world use case scenarios. A case study is used to add further evidence.

The Catholic Internet discussion on cloning : A study in cognitive rhetoric

This work combines the cognitive theory of folk-theoretical thought with the classical Aristotelian theory of artistic proof in rhetoric. The first half of the work discusses the common ground shared by the elements of artistic proof (logos, pathos, ethos) and the elements of folk-theoretical thought (naïve physics, folk biology, folk psychology, naïve sociology). Combining rhetoric with the cognitive theory of folk-theoretical thought creates a new point of view for argumentation analysis. The logos of an argument can be understood as the inferential relations established between the different parts of an argument. Consequently, within this study the analysis of logos is to be viewed as the analysis of the inferential folk-theoretical elements that make the suggested factual states-of-things appear plausible within given argumentative structures. The pathos of an argumentative structure can be understood as determining the quality of the argumentation in question in the sense that emotive elements play a great part in what can be called a distinction between good and deceptive rhetoric. In the context of this study the analysis of pathos is to be viewed as the analysis of the emotive content of argumentative structures and of whether they aim at facilitating surface- or deep cognitive elaboration of the suggested matters. The ethos of an argumentative structure means both the speaker-presentation and audience-construct that can be discerned within a body of argumentation. In the context of this study, the analysis of ethos is to be understood as the analysis of mutually manifest cognitive environments in the context of argumentation. The theory is used to analyse Catholic Internet discussion concerning cloning. The discussion is divided into six themes: Human Dignity, Sacred Family, Exploitation / Dehumanisation, Playing God, Monsters and Horror Scenarios and Ensoulment. Each theme is analysed for both the rhetorical and the cognitive elements that can be seen creating persuasive force within the argumentative structures presented. It is apparent that the Catholic voices on the Internet extensively oppose cloning. The voices utilise rhetoric that is aggressive and pejorative more often than not. Furthermore, deceptive rhetoric (in the sense presented above) plays a great part in argumentative structures of the Catholic voices. The theory of folk-theoretical thought can be seen as a useful tool for analysing the possible reasons why the Catholic speakers think about cloning and choose to present cloning in their argumentation as they do. The logos utilized in the argumentative structures presented can usually be viewed as based on folk-theoretical inference concerning biology and psychology. The structures of pathos utilized generally appear to aim at generating fear appeal in the assumed audiences, often incorporating counter-intuitive elements. The ethos utilised in the arguments generally revolves around Christian mythology and issues of social responsibility. These structures can also be viewed from the point of view of folk psychology and naïve sociological assumptions.

Essays on Banking Crises

This thesis aims at finding the role of deposit insurance scheme and central bank (CB) in keeping the banking system safe. The thesis also studies the factors associated with long-lasting banking crises. The first essay analyzes the effect of using explicit deposit insurance scheme (EDIS), instead of using implicit deposit insurance scheme (IDIS), on banking crises. The panel data for the period of 1980-2003 includes all countries for which the data on EDIS or IDIS exist. 70% of the countries in the sample are less developed countries (LDCs). About 55% of the countries adopting EDIS also come from LDCs. The major finding is that the using of EDIS increases the crisis probability at a strong significance level. This probability is greater if the EDIS is inefficiently designed allowing higher scope of moral hazard problem. Specifically, the probability is greater if the EDIS provides higher coverage to deposits and if it is less powerful from the legal point of view. This study also finds that the less developed a country is to handle EDIS, the higher the chance of banking crisis. Once the underdevelopment of an economy handling the EDIS is controlled, the EDIS separately is no longer a significant factor of banking crises. The second essay aims at determining whether a country s powerful CB can lessen the instability of the banking sector by minimizing the likelihood of a banking crisis. The data used include indicators of the CB s autonomy for a set of countries over the period of 1980-89. The study finds that in aggregate a more powerful CB lessens the probability of banking crisis. When the CB s authority is disentangled with respect to its responsibilities, the study finds that the longer tenure of CB s chief executive officer and the greater power of CB in assigning interest rate on government loans are necessary for reducing the probability of banking crisis. The study also finds that the probability of crisis reduces more if an autonomous CB can perform its duties in a country with stronger law and order tradition. The costs of long-lasting banking crises are high because both the depositors and the investors lose confidence in the banking system. For a rapid recovery of a crisis, the government very often undertakes one or more crisis resolution policy (CRP) measures. The third essay examines the CRP and other explanatory variables correlated with the durations of banking crises. The major finding is that the CRP measure allowing the regulation forbearance to keep the insolvent banks operative and the public debt relief program are respectively strongly and weakly significant to increase the durations of crises. Some other explanatory variables, which were found by previous studies to be related with the probability of crises to occur, are also correlated with the durations of crises.

Internet- ja postikysely osallistavan suunnittelun menetelmänä Puijon metsäsuunnitteluprosessissa

Osallistavan suunnittelun määrä Suomessa on viime vuosina kasvanut huomattavasti. Asukaskyselyt ovat yksi tapa osallistaa asukkaita, ja ne sopivat erityisesti suuren yleisön osallistamiseen. Internetissä toteutetut asukaskyselyt nopeuttaisivat ja helpottaisivat asukaskyselyiden tekemistä mm. siksi, että tieto voidaan tallentaa suoraan sähköiseen muotoon. Internetin käyttö asukaskyselyiden tekemisessä on kuitenkin uusi menetelmä, josta on vasta vähän tutkimustietoa. Ongelmallista Internet-kyselyissä on se, että kasvaneista käyttäjämääristä huolimatta kaikilla ei edelleenkään ole mahdollisuutta käyttää Internetiä. Lisäksi Internet-kyselyn otos on yleensä valikoitunut ja otoskoon määritteleminen on hankalaa. Tutkielma toteutettiin osana Kuopion kaupungin Puijon alueen vuorovaikutteista suunnitteluprosessia. Tutkielman tavoitteena oli vertailla Internet-kyselyä postikyselyyn, jotta saataisiin selville, onko Internet-kysely kelvollinen osallistamismenetelmä. Lisäksi tavoitteena oli profiloida vastaajia mielipiteiden ja taustamuuttujien perusteella. Tutkielman aineistona oli Kuopiossa tammikuussa 2009 toteutetun, Puijon aluetta koskevan asukaskyselyn tulokset. Aineiston analysointiin käytettiin faktorianalyysia, klusterianalyysia, erotteluanalyysia ja korrespondenssianalyysia. Katoa tutkittiin ?2-testillä ja laskemalla ristitulosuhteet. Sekä Internet- että postikyselyn vastaajista muodostuivat Tyytymättömien, Tyytyväisten ja Luonnonsuojelijoiden vastaajaryhmät, joilla olivat melko samanlaiset mielipiteet ja taustamuuttujat molemmissa aineistoissa. Tyytymättömät olivat tyytymättömiä Puijon alueen nykytilaan eivätkä arvostaneet Puijoa. Myös Luonnonsuojelijat olivat tyytymättömiä Puijon alueen ja metsien nykyiseen hoitoon, mutta eivät kannattaneet metsänhoitoa. Tyytyväisten mielestä Puijon alueella kaikki on nyt kunnossa. Lisäksi postikyselyn aineistosta muodostui Kehittäjät-ryhmä ja Internet-kyselyn vastaajista Virkistäytyjät-ryhmä. Internet-kyselyssä 46–60-vuotiaat ja korkeakoulutetut olivat yliedustettuina, mutta kummallakaan kyselyllä ei saatu edustavaa otosta kuopiolaisista. Katoa oli paljon. Edes keskustelua herättänyt aihe ei riittänyt aktivoimaan kuopiolaisia vastaamaan kyselyyn ja tutkielmassa käytettyjen tutkimusmenetelmien kannalta kyselylomake oli puutteellinen. Tämän tutkielman tuloksista saatiin lopulta lähinnä suuntaviivoja Puijon suunnitelmaehdotuksille. Kunnissa tarvitaan uusia työkaluja osallistamiseen, ja tähän tarpeeseen Internet-kysely olisi kustannustehokas vastaus. Sen vuoksi Internet-kyselyä kannattaa edelleen tutkia ja kehittää. Internet-kyselyllä olisi mahdollista saada edustavampi otos, jos vastaajat valittaisiin satunnaisotannalla ja he saisivat salasanan kyselyyn. Myös kaikille avoimella kyselyllä voitaisiin kartoittaa mielipiteitä, kunhan tuloksia tulkittaisiin kriittisesti.

How Scientists Retrieve Publications: An Empirical Study of How the Internet Is Overtaking Paper Media

The current mainstream scientific-publication process has so far been only marginally affected by the possibilities offered by the Internet, despite some pioneering attempts with free electronic-only journals and electronic preprint archives. Additional electronic versions of traditional paper journals for which one needs a subscription are not a solution. A clear trend, for young researchers in particular, is to go around subscription barriers (both for paper and electronic material) and rely almost exclusively on what they can find free on the Internet, which often includes working versions posted on the home pages of the authors. A survey of how scientists retrieve publications was conducted in February 2000, aimed at measuring to what extent the opportunities offered by the Internet are already changing the scientific information exchange and how researchers feel about this. This paper presents the results based on 236 replies to an extensive Web-based questionnaire, which was announced to around 3,000 researchers in the domains of construction information technology and construction management. The questions dealt with how researchers find, access, and read different sources; how many and what publications they read; how often and to which conferences they travel; how much they publish, and criteria for where they eventually decide to publish. Some of the questions confronted traditional and electronic publishing, with one final section dedicated to opinions about electronic publishing. According to the survey, researchers already download half of the material that they read digitally from the Web. The most popular method for retrieving an interesting publication is downloading it for free from the author's or publisher's Web site. Researchers are not particularly willing to pay for electronic scientific publications. There is much support for a scenario of electronic journals available freely in their entirety on the Web, where the costs could be covered by, for instance, professional societies or the publishing university.

How do Researchers Find and Retrieve Scientific Publications – A Case study of the Impact of the Internet on the Construction IT and Construction Management Research Communities

The World Wide Web provides the opportunity for a radically changed and much more efficient communication process for scientific results. A survey in the closely related domains of construction information technology and construction management was conducted in February 2000, aimed at measuring to what extent these opportunities are already changing the scientific information exchange and how researchers feel about the changes. The paper presents the results based on 236 replies to an extensive Web based questionnaire. 65% of the respondents stated their primary research interest as IT in A/E/C and 20% as construction management and economics. The questions dealt with how researchers find, access and read different sources; how much and what publications they read; how often and to which conferences they travel; how much they publish, and what are the criteria for where they eventually decide to publish. Some of the questions confronted traditional and electronic publishing with one final section dedicated to opinions about electronic publishing. According to the survey researchers already download half of the material that they read digitally from the Web. The most popular method for retrieving an interesting publication is downloading it for free from the author’s or publisher’s website. Researchers are not particularly willing to pay for electronic scientific publications. There is much support for a scenario of electronic journals available totally freely on the Web, where the costs could be covered by for instance professional societies or the publishing university. The shift that the Web is causing seems to be towards the "just in time" reading of literature. Also, frequent users of the Web rely less on scientific publications and tend to read fewer articles. If available with little effort, papers published in traditional journals are preferred; if not, the papers should be on the Web. In these circumstances, the role of paper-based journals published by established publishers is shifting from the core "information exchange" to the building of authors' prestige. The respondents feel they should build up their reputations by publishing in journals and relevant conferences, but then make their work freely available on the Web.

Information Sharing in Banking: A Collusive Device?

We show that information sharing among banks may serve as a collusive device. An informational sharing agreement is an a-priori commitment to reduce informational asymmetries between banks in future lending. Hence, information sharing tends to increase the intensity of competition in future periods and, thus, reduces the value of informational rents in current competition. We contribute to the existing literature by emphasizing that a reduction in informational rents will also reduce the intensity of competition in the current period, thereby reducing competitive pressure in current credit markets. We provide a large class of economic environments, where a ban on information sharing would be strictly welfare-enhancing.