New and Emerging Challenges of the ICT-Mediated Health and Well-Being Services

This monograph dissertation looks into the field of ICT-mediated health and well-being services. Through six chapters that extend the work done in the reviewed and published articles, the dissertation focuses on new and emerging technologies, and to impact of their use on the beneficiary; the individual who eventually derives advantage from the services. As the field is currently going through major changes particularly in the OECD countries, the focus is on shortterm developments in the field and the analysis on the long term developments is cursory by nature. The dissertation includes theoretical and empirical elements. Most of the empirical elements are linked to product development and conceptualization performed in the national MyWellbeing project that ended in 2010. In the project, the emphasis was on conceptualization of a personal aid for the beneficiary that could be used for managing information and services in the field of health and well-being services. This work continued the theme of developing individual-centric solutions for the field; a work that started in the InnoElli Senior program in 2006. The nature of this thesis is foremost a conceptual elaboration based on a literature review, illustrated in empirical work performed in different projects. As a theoretical contribution, this dissertation elaborates the role of a mediator, i.e. an intermediary, and it is used as an overarching theme. The role acts as a ‘lens’ through which a number of technology-related phenomena are looked at, pinned down and addressed to a degree. This includes introduction of solutions, ranging from anthropomorphic artefacts to decision support systems that may change the way individuals experience clinical encounters in the near-future. Due to the complex and multiform nature of the field, it is impractical and effectively impossible to cover all aspects that are related to mediation in a single work. Issues such as legislation, financing and privacy are all of equal importance. Consideration of all these issues is beyond the scope of this dissertation and their investigation is left to other work. It follows from this that the investigation on the role is not intended as inclusive one. The role of the mediator is also used to highlight some of the ethical issues related to personal health information management, and to mediating health and well-being related issues on behalf of another individual, such as an elderly relative or a fellow member of a small unit in the armed forces. The dissertation concludes in a summary about the use and functions of the mediator, describing some potential avenues for implementing such support mechanisms to the changing field of ICT-mediated health and well-being services. The conclusions also describe some of the limitations of this dissertation, including remarks on methodology and content.

My repository is being aggregated: a blessing or a curse?

Presentation at Open Repositories 2014, Helsinki, Finland, June 9-13, 2014

Feeling vs. Being like a Domestic Goddess: Cookbooks and Lifestyle Choices

Tämä pro gradu -tutkielma tarkastelee, miten keittokirjat muovaavat pääasiassa naispuolista lukijakuntaansa. Tärkein kysymys, johon tutkielmassa on etsitty vastausta on, että onko naisilla, menneiden sukupolvien taisteltua vuosikymmeniä tasa-arvon puolesta, oikeus valita viettää aikaa keittiössä ja oikeasti nauttiakin siitä. Kahtena päälähteenä tutkielmassa on käytetty brittiläisen Nigella Lawsonin keittokirjoja How to Eat ja How to be a Domestic Goddess. Näiden kirjojen analysoinnin ja muiden lähteiden avulla tutkielmassa on käsitelty ruuanlaiton ja leipomisen nautittavuutta ja sitä onko se ylipäätään sallittua vai syntistä. Lawson on julkaissut urallaan sitten vuoden 1998 yhteensä yhdeksän keittokirjaa, joiden lisäksi kirjojen tueksi on tehty useita televisiosarjoja. How to Eat on yleispätevä opas hyvän ruuan nautintoihin ja periaatteisiin, How to be a Domestic Goddess taas sisältää lähinnä leivontareseptejä. Nämä kaksi kirjaa ovat Lawsonin ensimmäiset keittokirjat. Nigella Lawsonin keittokirjat eivät ole vain reseptikokelmia eivätkä reseptit vain aineisosalistoja ja valmistusohjeita. Lawsonin kirjoja voi lukea kirjallisuutena eikä vain reseptien takia. Lawson viittaa usein naisen asemaan ja yrittää vakuuttaa lukijoitaan ruuanlaiton ja leipomisen nautittavuudesta.

Psychological well-being of the parents and child development, behavior, and quality of life in very low birth weight infants

The parents of premature infants, especially the mothers, are at increased risk for distress. Infants born prematurely are at risk for developmental problems. The aim of this study was to investigate whether the psychological well-being of both parents is associated with child development in very low birth weight (VLBW, ≤1500g) children. The burden of prematurity-related morbidity to the children and to the family was also assessed. A cohort of 201 VLBW infants born during 2001–2006 in the Turku University Hospital, Finland, and their parents were studied (I–IV). One study included a control group (n=166) of full-term infants (IV). The psychological well-being of the parents was evaluated by assessments of depressive symptoms, parenting stress, the sense of coherence and general family functioning. Cognitive, behavioral, and socio-emotional development, and the health-related quality of life (HRQoL) of the children were determined when the children were 2 to 8 years old. The psychological well-being of the parents was associated with the cognitive, behavioral and social development of the VLBW children. The VLBW infants with prematurity-related morbidities had a poorer HRQoL and the general functioning of the family was inferior compared to the control children and their families. 64.5% of the VLBW children survived without morbidities. Most of the VLBW children did not have significant behavior problems (93%), had normal social skills (63%), had no emotional problems (64%), and had no problems in executive functioning (62%). Only 3% of the surviving VLBW infants had significant cognitive delay. In conclusion, the depressive symptoms and stress of the parents can be risk factors for disadvantageous child development, while a strong sense of coherence can be protective. Parents of the premature children with developmental delays might also experience more depressive symptoms and stress than other parents. Prematurity-related morbidities were a burden to the VLBW child as well as to the family.

”Far from being such untameable savages” - Australian ja Uuden-Seelannin alkuperäiskansat Britannian parlamentin komitearaporteissa 1830- ja 40-luvuilla

Käsittelen tutkielmassani Australian aboriginaaleista ja Uuden-Seelannin maoreista 1830- ja 1840-luvuilla Britannian hallinnossa esitettyjä kuvauksia. Lähteenä aiheen tarkasteluun käytän viiden Britannian parlamentin tuona aikana asettaman komitean raportteja, joissa käsitellään Australian ja Uuden-Seelannin tilaa suhteessa eurooppalaisiin siirtolaisiin ja näiden alueiden kolonisoimista. Yhdessä nämä viisi raporttia muodostavat kiinnostavan kokonaisuuden, sillä ne ovat 1800-luvun ensimmäisen puoliskon ainoat komitearaportit, joissa käsitellään aboriginaaleja ja maoreja. Ne olivat myös yksi tapa, jolla 1800-luvulla siirtokunnista saatiin tietoa Britannian hallintoon, joten niissä esitetyt kuvaukset olivat merkittävä osa tiedonkulkua siirtokunnista imperiumin metropoliin. Tutkielmassani selvitän millaista kuvaa komiteat loivat aboriginaaleista ja maoreista metropolissa toimineelle hallinnolle siirtomaista peräisin olleiden lähteiden perusteella. Tarkastelen komiteoiden raporteissaan esittämiä kuvauksia aboriginaaleista ja maoreista suhteessa komiteoita ympäröineeseen ajatteluun ja muiden käsittelemieni komiteoiden esittämiin näkemyksiin. Rinnastamalla raporteissa esitettyjä kuvauksia ja näkemyksiä laajempaan aikalaiseen ajatteluun pystyn tuomaan esille komiteoiden esittämistä näkemyksistä niin samankaltaisuuksia verrattuna laajempaan ajatteluun kuin ajalleen poikkeuksellisia näkemyksiä. Komiteoiden esittämien näkemysten suhteuttaminen myös raporttien taustalla olleisiin todistajalausuntoihin tuo esille komiteoiden omia suuntautumisia. Komiteoiden raporteissa aboriginaalit ja maorit näyttäytyvät keskenään hyvin erilaisina kansoina monilla eri perusteilla. Maoreista luodaan raporteissa kuvaa aboriginaaleja kehittyneempinä ja sivistyneempinä, mikä perustuu niin maorien kehittyneempiin elinkeinoihin, yhteiskunnalliseen organisoitumiseen, kykeneväisyyteen toimia aktiivisena osapuolena kanssakäymisessä eurooppalaisten kanssa ja toisaalta aboriginaalien jo alunalkaen alhaiseen tilaan. Eri raportit kuitenkin kuvaavat maoreja ja aboriginaaleja kuitenkin hyvin eri tavoilla, ja erityisesti komiteoiden omat motiivit ja tavoitteet näyttävät vaikuttaneen tapoihin, joilla näitä kansoja kuvataan. Voimakkaana vastakkainasetteluna näyttäytyy humanitaarinen, lähetystyötä korostava positiivisempi tapa kuvata kansoja ja kolonisaatiota sekä siirtolaisten etuja ajaneet negatiivisemmat kuvaukset. Komiteoiden käsittely kuitenkin perustuu lähes täysin eurooppalaiseen näkökulmaan ja eurooppalaisiin normeihin, eikä näiden kansojen kulttuuria tuoda juurikaan esille.

Ethical leadership as a way to promote work-related well-being

The purpose of this study was to clarify the connections of ethical leadership with the work-related well-being of employees. Additionally, the role of occupational health care in ethical leadership that promotes work-related well- being was analyzed. The objective of the study was to produce knowledge to support the development of ethical leadership and work-related well-being as well as to find ways for occupational health care to support organizations in these actions. The target groups of this study consisted of the managers (N=43) and employees (N=336) working in one organization in the Finnish energy industry. The population was studied in November 2014 using census. The data was gathered with two different web-based surveys containing structured and open questions. The survey for managers consisted of background questions and statements concerning ethical leadership, work-related well-being and occupational health care. The employee questionnaire consisted of questions about background and statements about work-related well-being and ethical leadership. The structured questions were analyzed with SPSS Statistical Program and the open questions using inductive content analysis. At least 80 % of the managers saw their actions as ethical in all but one part of ethical leadership. The work-related well-being of the employees was found best in the area of ability to work (91 % agreed) and lowest in the area of experience of ethical leadership (67 % agreed). The results showed a strong positive connection between ethical leadership and all the components of work- related well-being. The managers and employees were generally quite happy with the services of occupational health care but managers saw some problems with the collaboration with occupational health care. Several ways to improve work-related well-being and collaboration with occupational health care were found. One of the most important things was thought to be offering ways to maintain ability to work and making these actions visible. Investing in ethical leadership and work-related well-being is extremely important for the success of an organization and the societal benefits cannot be forgotten either. The role of occupational health care in promoting the health and well-being of employees is substantial. Occupational health care should offer managers more tools to recognize difficult situations and acting in them as well as encourage managers to seek help from occupational health care without hesitation in problematic situations of leadership.

Ethical leadership as a way to promote work-related well-being

The purpose of this study was to clarify the connections of ethical leadership with the work-related well-being of employees. Additionally, the role of occupational health care in ethical leadership that promotes work-related well- being was analyzed. The objective of the study was to produce knowledge to support the development of ethical leadership and work-related well-being as well as to find ways for occupational health care to support organizations in these actions. The target groups of this study consisted of the managers (N=43) and employees (N=336) working in one organization in the Finnish energy industry. The population was studied in November 2014 using census. The data was gathered with two different web-based surveys containing structured and open questions. The survey for managers consisted of background questions and statements concerning ethical leadership, work-related well-being and occupational health care. The employee questionnaire consisted of questions about background and statements about work-related well-being and ethical leadership. The structured questions were analyzed with SPSS Statistical Program and the open questions using inductive content analysis. At least 80 % of the managers saw their actions as ethical in all but one part of ethical leadership. The work-related well-being of the employees was found best in the area of ability to work (91 % agreed) and lowest in the area of experience of ethical leadership (67 % agreed). The results showed a strong positive connection between ethical leadership and all the components of work- related well-being. The managers and employees were generally quite happy with the services of occupational health care but managers saw some problems with the collaboration with occupational health care. Several ways to improve work-related well-being and collaboration with occupational health care were found. One of the most important things was thought to be offering ways to maintain ability to work and making these actions visible. Investing in ethical leadership and work-related well-being is extremely important for the success of an organization and the societal benefits cannot be forgotten either. The role of occupational health care in promoting the health and well-being of employees is substantial. Occupational health care should offer managers more tools to recognize difficult situations and acting in them as well as encourage managers to seek help from occupational health care without hesitation in problematic situations of leadership.