Quality of radiotherapy care by development of e-feedback knowledge

The aim of this three phase study was to develop quality of radiotherapy care by the e-Feedback knowledge of radiotherapy -intervention (e-Re-Know). In Phase I, the purpose was to describe the quality of radiotherapy care and its deficits experienced by cancer patients. Based on the deficits in patient education in Phase II, the purpose was to describe cancer patients’ e-knowledge expectations in radiotherapy. In Phase III, the purpose was to develop and evaluate the outcomes of the e-Re-Know among breast cancer patients. The ultimate aim was to develop radiotherapy care to support patients’ empowerment with patient e-education. In Phase I (2004-2005), the descriptive design was used, and 134 radiotherapy patients evaluated their experiences by Good Nursing Care Scale for Patients (GNCS-P) in the middle of RT period. In Phase II (2006-2008), the descriptive longitudinal design was used and 100 radiotherapy patients’ e-knowledge expectations of RT were evaluated using open-ended questionnaire developed for this study before commencing first RT, in the middle of the treatment, and concluding RT period. In Phase III, firstly (2009-2010), the e-Re-Know intervention, i.e. knowledge test and feedback, was developed in terms of empowering knowledge and implemented with e-feedback approach based on literature and expert reviews. Secondly (2011-2014), the randomized controlled study was used to evaluate the e-Re-Know. Breast cancer patients randomized to either the intervention group (n=65) receiving the e-Re-Know by e-mail before commencing first RT and standard education or the control group (n=63) receiving standard education. The data were collected before commencing first RT, concluding last RT and 3 months after last RT using RT Knowledge Test, Spielberger’s State Trait Inventory (STAI) and Functional Assessment of Cancer Therapy - Breast (FACT-B) –instruments. Data were analyzed using statistical methods and content analysis. The study showed radiotherapy patients experienced quality of care high. However, there were deficits in patient education. Furthermore, radiotherapy patients’ multidimensional e-knowledge expectations through Internet covered mainly bio-physiological and functional knowledge. Thus, the e-Re-Know was developed and evaluated. The study showed when breast cancer patients’ carried out the e-Re-Know their knowledge of side effects self-care was significantly increased and quality of life (QOL) significantly improved in line with decrease in anxiety from time before radiotherapy period to three months after. In addition, the e-Re-Know has potential to have positive effects on anxiety and QOL, regardless of patient characteristics or knowledge level. The results support the theory of empowering patient education suggesting that empowerment can be supported by confirming patients’ understanding of own knowledge level. In summary, the e-Feedback knowledge of radiotherapy (e-Re-Know) intervention can be recommended in development of quality of radiotherapy care experienced by breast cancer patients. Further research is needed to assess and develop patient-centred quality of care by patient education among cancer patients.

Organizing for Systemic Innovations – Research on Knowledge, Interaction and Organizational Interdependencies

Systemic innovation has emerged as an important topic due to the interconnected technological and sociotechnical change of our current complex world. This study approaches the phenomenon from an organizing perspective, by analyzing the various actors, collaborative activities and resources available in innovation systems. It presents knowledge production for innovation and discusses the organizational challenges of shared innovation activities from a dynamic perspective. Knowledge, interaction, and organizational interdependencies are seen as the core elements of organizing for systemic innovations. This dissertation is divided into two parts. The first part introduces the focus of the study and the relevant literature and summarizes conclusions. The second part includes seven publications, each reporting on an important aspect of the phenomenon studied. Each of the in-depth single-case studies takes a distinct and complementary systems approach to innovation activities – linking the refining of knowledge to the enabling of organizations to participate in shared innovation processes. These aspects are summarized as theoretical and practical implications for recognizing innovation opportunities and turning ideas into innovations by means of using information and organizing activities in an efficient manner. Through its investigation of the existing literature and empirical case studies, this study makes three main contributions. First, it describes the challenges inherent in utilizing information and transforming it into innovation knowledge. Secondly, it presents the role of interaction and organizational interdependencies in innovation activities from various novel perspectives. Third, it highlights the interconnection between innovations and organizations, and the related path dependency and anticipatory aspects in innovation activities. In general, the thesis adds to our knowledge of how different aspects of systems form innovations through interaction and organizational interdependencies. It highlights the continuous need to redefine information and adjust organizations and networks based on ongoing activities – stressing the emergent, systemic nature of innovation.

Extended hydrogen photoproduction by nitrogen-fixing cyanobacteria

Cyanobacteria are the only prokaryotic organisms performing oxygenic photosynthesis. They comprise a diverse and versatile group of organisms in aquatic and terrestrial environments. Increasing genomic and proteomic data launches wide possibilities for their employment in various biotechnical applications. For example, cyanobacteria can use solar energy to produce H2. There are three different enzymes that are directly involved in cyanobacterial H2 metabolism: nitrogenase (nif) which produces hydrogen as a byproduct in nitrogen fixation; bidirectional hydrogenase (hox) which functions both in uptake and in production of H2; and uptake hydrogenase (hup) which recycles the H2 produced by nitrogenase back for the utilization of the cell. Cyanobacterial strains from University of Helsinki Cyanobacteria Collection (UHCC), isolated from the Baltic Sea and Finnish lakes were screened for efficient H2 producers. Screening about 400 strains revealed several promising candidates producing similar amounts of H2 (during light) as the ΔhupL mutant of Anabaena PCC 7120, which is specifically engineered to produce higher amounts of H2 by the interruption of uptake hydrogenase. The optimal environmental conditions for H2 photoproduction were significantly different between various cyanobacterial strains. All suitable strains revealed during screening were N2-fixing, filamentous and heterocystous. The top ten H2 producers were characterized for the presence and activity of the enzymes involved in H2 metabolism. They all possess the genes encoding the conventional nitrogenase (nifHDK1). However, the high H2 photoproduction rates of these strains were shown not to be directly associated with the maximum capacities of highly active nitrogenase or bidirectional hydrogenase. Most of the good producers possessed a highly active uptake hydrogenase, which has been considered as an obstacle for efficient H2 production. Among the newly revealed best H2 producing strains, Calothrix 336/3 was chosen for further, detailed characterization. Comparative analysis of the structure of the nif and hup operons encoding the nitrogenase and uptake hydrogenase enzymes respectively showed minor differences between Calothrix 336/3 and other N2-fixing model cyanobacteria. Calothrix 336/3 is a filamentous, N2-fixing cyanobacterium with ellipsoidal, terminal heterocysts. A common feature of Calothrix 336/3 is that the cells readily adhere to substrates. To make use of this feature, and to additionally improve H2 photoproduction capacity of the Calothrix 336/3 strain, an immobilization technique was applied. The effects of immobilization within thin alginate films were evaluated by examining the photoproduction of H2 of immobilized Calothrix 336/3 in comparison to model strains, the Anabaena PCC 7120 and its ΔhupL mutant. In order to achieve optimal H2 photoproduction, cells were kept under nitrogen starved conditions (Ar atmosphere) to ensure the selective function of nitrogenase in reducing protons to H2. For extended H2 photoproduction, cells require CO2 for maintenance of photosynthetic activity and recovery cycles to fix N2. Application of regular H2 production and recovery cycles, Ar or air atmospheres respectively, resulted in prolongation of H2 photoproduction in both Calothrix 336/3 and the ΔhupL mutant of Anabaena PCC 7120. However, recovery cycles, consisting of air supplemented with CO2, induced a strong C/N unbalance in the ΔhupL mutant leading to a decrease in photosynthetic activity, although total H2 yield was still higher compared to the wild-type strain. My findings provide information about the diversity of cyanobacterial H2 capacities and mechanisms and provide knowledge of the possibilities of further enhancing cyanobacterial H2 production.

Nurse Competence of Graduating Nursing Students

The competence of graduating nursing students is an important issue in health care as it is related to professional standards, patient safety and the quality of nursing care. Many changes in health care lead to increased demand with respect to nurses’ competence as well the number of nurses. The purpose of this empirical study was to i) describe the nurse competence areas of nursing students in Europe, ii) evaluate the nurse competence of graduating nursing students, iii) identify factors related to the nurse competence, and to iv) assess the congruence between graduating nursing students’ self-assessments and their mentors’ assessments of students’ nurse competence. The study was carried out in two phases: descriptive phase and evaluation phase. The descriptive phase focused on describing the nurse competence areas of nursing students in Europe with the help of a literature review (n=10 empirical studies and n=4 additional documents). Thematic analysis was used as the analysis method. In the evaluation phase, the nurse competence with particular focus on nursing skills of graduating nursing students (n=154) was assessed. In addition, factors related to the nurse competence were examined. Also, the congruence between graduating nursing students’ self-assessments and their mentors’ assessments of students’ nurse competence was evaluated by comparing graduating nursing students’ self-assessments with the assessments by their mentors (n=42) in the final clinical placement in four university hospitals. Descriptive statistics and inferential statistics were used to analyse the data. Based on the results, the nurse competence of nursing students in Europe consists of nine main competence areas: (1) professional/ethical values and practice, (2) nursing skills and interventions, (3) communication and interpersonal skills, (4) knowledge and cognitive ability, (5) assessment and improving quality in nursing, (6) professional development, (7) leadership, management and teamwork, (8) teaching and supervision, and (9) research utilization. Graduating nursing students self-assessed their nurse competence as good. However, when graduating nursing students’ nurse competence was assessed by their mentors, the results were poorer. Readiness for practice based on nurse education, pedagogical atmosphere on the ward, supervisory relationship between student and mentor and being in paid work in health care at the moment of the study were the most significant factors related to the nurse competence. Conclusions: Nurse competence can be evaluated with a scale based on self-assessment, but other evaluation methods could be used alongside to ensure that nurse competence can be completed and evaluated critically. Practical implications are presented for nurse education and nursing practice. In future, longitudinal research is needed in order to understand the development of nurse competence during nurse education and the transition process from a nursing student to a professional nurse.

Asiantuntijuuden hyödyntäminen pk-yritysten hallitustyössä

TIIVISTELMÄ Tekijä: Kirsi Mikkilä Tutkielman nimi: Asiantuntijuuden hyödyntäminen pk-yritysten hallitustyössä Tiedekunta: Kauppatieteellinen tiedekunta Pääaine: Yrittäjyys ja pk-yrityksen johtaminen Vuosi: 2014 Pro gradu -tutkielma: Lappeenrannan teknillinen yliopisto 103 sivua, 9 kuvioa ja 2 liitettä. Tarkastajat: KTT, prof. Timo Pihkala ja KTT, prof. Markku Ikävalko Hakusanat: hallitus, pk-yritys, asiantuntijuus Pk-yrityksen hallitustyö on yksi keskeisimmistä johtamisen välineistä, jonka avulla yritys voi mahdollistaa kasvunsa ja tuottaa omistajien sijoittamalle pääomalle parempaa tuottoa. Tämän tutkimuksen tavoitteena oli tarkastella asiantuntijuuden käyttöä pk-yritysten hallitustyöskentelyssä. Tutkimuksella etsittiin vastauksia kysymyksiin, missä yrityksen kehitysvaiheissa asiantuntijuutta lisätään hallituksessa, mitä sillä halutaan saavuttaa ja miten prosessiin valmistaudutaan. Tavoitteena oli täydentää tietämystä pk-yrityksen hallitustyön muuttumisen ja hallituksen laajenemisen mahdollisuuksista ja syistä. Tutkimus toteutettiin haastattelututkimuksena. Tutkimuksen kohdeorganisaatioiksi valittiin viisi teollisuudenalan koneiden, laitteiden ja tuotteiden toimittajayritystä Päijät-Hämeen alueelta. Tutkimusaineisto kerättiin keväällä 2014 teemahaastatteluina. Tutkimus vahvisti resurssiperustaisen näkökulman nousevan vahvasti esiin pk-yrityksien muutosvaiheista. Hallitustyö ja hallituksen jäsenten osaaminen korostui kasvuhakuisuuden lisääntyessä. Agenttiteoria sai vahvistusta omistajajäsenten valvonnan tarpeen painottuessa ja stewardship -teorian mukaisesti hallitusammattilaiset katsoivat osaamisensa hyödyntämisen olevan palkitsemista tärkeämpää.

Utilization of AMI-Technology in a Multilayered Demand Response Service Environment

This thesis studied the performance of Advanced metering infrastructure systems in a challenging Demand Response environment. The aim was to find out what kind of challenges and bottlenecks could be met when utilizing AMI-systems in challenging Demand Response tasks. To find out the challenges and bottlenecks, a multilayered demand response service concept was formed. The service consists of seven different market layers which consist of Nordic electricity market and the reserve markets of Fingrid. In the simulations the AMI-systems were benchmarked against these seven market layers. It was found out, that the current generation AMI-systems were capable of delivering Demand Response on the most challenging market layers, when observed from time critical viewpoint. Additionally, it was found out, that to enable wide scale Demand Response there are three major challenges to be acknowledged. The challenges hindering the utilization of wide scale Demand Response were related to poor standardization of the systems in use, possible problems in data connectivity solutions and the current electricity market regulation model.

Y-sukupolven johtaminen – odotukset esimiestyöltä

Y-sukupolven oikeantyylinen johtaminen sekä osaamisen hyödyntäminen ja kehittäminen ovat johtamisen haasteena organisaatioissa, jotka toimivat digitaalista osaamista vaativien tuotteiden ja palvelujen parissa. Tämän tutkimuksen tarkoituksena oli tutkia, minkälaisia odotuksia Y-sukupolvella on esimiestyötä ja johtamista kohtaan. Tutkimuksen tavoitteena oli tuottaa tutkimuksen kohdeyrityksen johtamisen kehittämistä varten nuorten työntekijöiden odotukset heihin kohdistuvasta esimiestyöstä. Tutkimuksen tavoitteena oli myös tuottaa tutkittua tietoa Y-sukupolven johtamista koskevaan keskusteluun. Tutkimus oli laadullinen tutkimus, joka toteutettiin haastattelemalla kohdeyrityksen nimeämästä joukosta 12 Y-sukupolven edustajaa. Tutkimusmenetelmänä oli puolistrukturoitu teemahaastattelu. Haastatteluissa kohderyhmään kuuluvat kertoivat omiin mielipiteisiinsä perustuen ajatuksiaan ja odotuksiaan tutkijan määrittämiin teemoihin. Haastatteluteemat olivat: työ ja työn merkitys, kokemukset ja odotukset esimieheen liittyen sekä heidän oman osaamisen hyödyntäminen ja kehittäminen. Tutkimuksen tuloksena havaittiin, että Y-sukupolvi odottaa esimiestyöltä ensisijaisesti johtamista. Esimiehen täytyy pitää organisaatiossa langat käsissään; toimia suunnannäyttäjänä, organisoida ja olla jämäkkä. Esimiehen tulee olla ominaisuuksiltaan kyvyiltään sellainen, jonka johtaminen on selkeää, oikeudenmukaista ja vuorovaikutteista. Y-sukupolvi odottaa selkeitä tavoitteita, oikeudenmukaista ja tasapuolista kohtelua ja palkkaa sekä jatkuvaa palautteeseen ja sparraamiseen liittyvää vuorovaikutusta esimiehen kanssa. Y-sukupolvi odottaa myös, että esimies hyödyntää ja kehittää heidän osaamistaan.

An Update on Inter-Country Differences in Recovery and Utilization of Recycled Paper

The use of recovered paper as raw material in the paper and board industry has increased heavily during recent decades. At the same time, growing environmental awareness has raised the interest in recycling and a more sustainable way of living, at least in high-income countries. This paper combines these topics and explores how economic, demographic and environmental factors have affected the recovery and utilization of recycled paper between 1992 and 2010 in a sample of 70 countries. This study updates and extends the previous research on the topic using panel data and panel data estimation methods. The results confirm the roles of economic determinants but also indicate that concern for the environment impacts the recovery of recycled paper particularly in high-income countries. Moreover, the motives for recycling appear to depend on the income level of a country, which is something that future policies should consider.

Biomass Utilization in PFC Co-firing System with the Slagging and Fouling Analysis

Master’s thesis Biomass Utilization in PFC Co-firing System with the Slagging and Fouling Analysis is the study of the modern technologies of different coal-firing systems: PFC system, FB system and GF system. The biomass co-fired with coal is represented by the research of the company Alstom Power Plant. Based on the back ground of the air pollution, greenhouse effect problems and the national fuel security today, the bioenergy utilization is more and more popular. However, the biomass is promoted to burn to decrease the emission amount of carbon dioxide and other air pollutions, new problems form like slagging and fouling, hot corrosion in the firing systems. Thesis represent the brief overview of different coal-firing systems utilized in the world, and focus on the biomass-coal co-firing in the PFC system. The biomass supply and how the PFC system is running are represented in the thesis. Additionally, the new problems of hot corrosion, slagging and fouling are mentioned. The slagging and fouling problem is simulated by using the software HSC Chemistry 6.1, and the emissions comparison between coal-firing and co-firing are simulated as well.

Liber fostering Open Science and Knowledge Discovery

Presentation of Kristiina Hormia-Poutanen at the 25th Anniversary Conference of The National Repository Library of Finland, Kuopio 22th of May 2015.

Deinking sludge utilization possibilities: technical, economic, and environmental assessments

This report introduces the ENPI project called “EMIR - Exploitation of Municipal and Industrial Residues” which was executed in a co-operation between Lappeenranta University of Technology (LUT), Saint Petersburg State University of Economics (SPbSUE), Saint Petersburg State Technical University of Plant Polymers (SPbSTUPP) and industrial partners from both Leningrad Region (LR), Russia and Finland. The main targets of the research were to identify the possibilities for deinking sludge management scenarios in co-operation with partner companies, to compare the sustainability of the alternatives, and to provide recommendations for the companies in the Leningrad Region on how to best manage deinking sludge. During the literature review, 24 deinking sludge utilization possibilities were identified, the majority falling under material recovery. Furthermore, 11 potential utilizers of deinking sludge were found within the search area determined by the transportation cost. Each potential utilizer was directly contacted in order to establish cooperation for deinking sludge utilization. Finally, four companies, namely, “Finnsementti” – a cement plant in Finland (S1), “St.Gobian Weber” – a light-weight aggregate plant in Finland (S2), “LSR-Cement” – a cement plant in LR (S3), and “Rockwool” – a stone wool plant in LR (S4) were seen as the most promising partners and were included in the economic and environmental assessments. Economic assessment using cost-benefit analysis (CBA) indicated that substitution of heavy fuel oil with dry deinking sludge in S2 was the most feasible option with a benefit/cost ratio (BCR) of 3.6 when all the sludge was utilized. At the same time, the use of 15% of the total sludge amount (the amount that could potentially be treated in the scenario) resulted in a BCR of only 0.16. The use of dry deinking sludge in the production of cement (S3) is a slightly more feasible option with a BCR of 1.1. The use of sludge in stone wool production is feasible only when all the deinking sludge is used and burned in an existing incineration plant. The least economically feasible utilization possibility is the use of sludge in cement production in Finland (S1) due to the high gate fee charged. Environmental assessment was performed applying internationally recognized life cycle assessment (LCA) methodologies: ISO 14040 and ISO 14044. The results of a consequential LCA stated that only S1 and S2 lead to a reduction of all environmental impacts within the impact categories chosen compared to the baseline scenario where deinking sludge is landfilled. Considering S1, the largest reduction of 13% was achieved for the global warming potential (GWP), whereas for S2, the largest decrease of abiotic depletion potential (ADP) was by 1.7%, the eutrophication potential (EP) by 1.8%, and a GWP of 2.1% was documented. In S3, the most notable increase of ADP and acidification potential (AP) by 2.6 and 1.5% was indicated, while the GWP was reduced by 12%, the largest out of all the impact categories. In S4, ADP and AP increased by 2.3 and 2.1% respectively, whereas ODP was reduced by 25%. During LCA, it was noticed that substitution of fuels causes a greater reduction of environmental impact (S1 and S2) than substitution of raw materials (S3 and S4). Despite a number of economically and environmentally acceptable deinking sludge utilization methods being assessed in the research, evaluation of bottlenecks and communications with companies’ representatives uncovered the fact that the availability of the raw materials consumed, and the risks associated with technological problems resulting from the sludge utilization, limited the willingness of industrial partners to start deinking sludge utilization. The research results are of high value for decision-makers at already existing paper mills since the result provide insights regarding alternatives to the deinking sludge utilization possibilities already applied. Thus, the research results support the maximum economic and environmental value recovery from waste paper utilization.

The northern provinces of Sweden and Norway with part I, of Russia / published under the superintendence of the Society for the Diffusion of Useful Knowledge.

[N. 1:4400000].

Pienet erikoiskaupat Big datan aikakaudella: Asiakastiedonjohtamisen edellyttämät strategiset orientaatiot.

This master’s thesis has examined how Entrepreneurial, Customer and Knowledge Management Orientations are needed in the use of Big data technology by small retail firms in their Customer Knowledge Management. A vision of the ability of small retailers to move to the Big data era is based on empirical evidence of owner-managers’ attitudes and the firms’ processes. Abductive content analysis was used as a research strategy and the qualitative data was collected through theme interviews of owner-managers of 11 small-size retail firms. The biggest obstacles to the use of Big data by small retail firms are: a lack of information about the new technology; a lack of Knowledge Management Orientation; and, a lack of proactive dimension in Entrepreneurial and Customer Orientations. A strong reactive customer-led orientation, and the ability of the owner-manager to system thinking will support Customer Knowledge Management development. The low stage of technology-use is preventing utilization of customer information. Co-operation between firms or with educational organizations may significantly enhance the use of Big data –technology by small retail firms.

Effect of the Knowledge Representation Form on the Efficiency of Knowledge Sharing

The goal of this thesis is to estimate the effect of the form of knowledge representation on the efficiency of knowledge sharing. The objectives include the design of an experimental framework which would allow to establish this effect, data collection, and statistical analysis of the collected data. The study follows the experimental quantitative design. The experimental questionnaire features three sample forms of knowledge: text, mind maps, concept maps. In the interview, these forms are presented to an interviewee, afterwards the knowledge sharing time and knowledge sharing quality are measured. According to the statistical analysis of 76 interviews, text performs worse in both knowledge sharing time and quality compared to visualized forms of knowledge representation. However, mind maps and concept maps do not differ in knowledge sharing time and quality, since this difference is not statistically significant. Since visualized structured forms of knowledge perform better than unstructured text in knowledge sharing, it is advised for companies to foster the usage of these forms in knowledge sharing processes inside the company. Aside of performance in knowledge sharing, the visualized structured forms are preferable due the possibility of their usage in the system of ontological knowledge management within an enterprise.