Datenherrschaft – an Ethically Justified Solution to the Problem of Ownership of Patient Information

Patient information systems are crucial components for the modern healthcare and medicine. It is obvious that without them the healthcare cannot function properly – one can try to imagine how brain surgery could be done without using information systems to gather and show information needed for an operation. Thus, it can be stated that digital information is irremovable part of modern healthcare. However, the legal ownership of patient information lacks a coherent and justified basis. The whole issue itself is actually bypassed by controlling pa- tient information with different laws and regulations how patient information can be used and by whom. Nonetheless, the issue itself – who owns the patient in- formation – is commonly missed or bypassed. This dissertation show the problems if the legislation of patient information ownership is not clear. Without clear legislation, the outcome can be unexpected like it seems to be in Finland, Sweden and United Kingdom: the lack of clear regulation has come up with unwanted consequences because of problematic Eu- ropean Union database directive implementation in those countries. The legal ownership is actually granted to the creators of databases which contains the pa- tient information, and this is not a desirable situation. In healthcare and medicine, we are dealing with issues such as life, health and information which are very sensitive and in many cases very personal. Thus, this dissertation leans on four philosophical theories form Locke, Kant, Heidegger and Rawls to have an ethically justified basis for regulating the patient infor- mation in a proper way. Because of the problems of property and ownership in the context of information, a new concept is needed and presented to replace the concept of owning, that concept being Datenherrschaft (eng. mastery over in- formation). Datenherrschaft seems to be suitable for regulating patient infor- mation because its core is the protection of one’s right over information and this aligns with the work of the philosophers whose theories are used in the work. The philosophical argumentation of this study shows that Datenherrschaft granted to the patients is ethically acceptable. It supports the view that patient should be controlling the patient information about themselves unless there are such specific circumstance that justifies the authorities to use patient information to protect other people’s basic rights. Thus, if the patients would be legally grant- ed Datenherrschaft over patient information we would endorse patients as indi- viduals who have their own and personal experience of their own life and have a strong stance against any unjustified paternalism in healthcare. Keywords: patient information, ownership, Datenherrschaft, ethics, Locke, Kant, Heidegger, Rawls

Public-private partnership investments in dry ports – Russian logistics markets and risks

The investments have always been considered as an essential backbone and so-called ‘locomotive’ for the competitive economies. However, in various countries, the state has been put under tight budget constraints for the investments in capital intensive projects. In response to this situation, the cooperation between public and private sector has grown based on public-private mechanism. The promotion of favorable arrangement for collaboration between public and private sectors for the provision of policies, services, and infrastructure in Russia can help to address the problems of dry ports development that neither municipalities nor the private sector can solve alone. Especially, the stimulation of public-private collaboration is significant under the exposure to externalities that affect the magnitude of the risks during all phases of project realization. In these circumstances, the risk in the projects also is becoming increasingly a part of joint research and risk management practice, which is viewed as a key approach, aiming to take active actions on existing global and specific factors of uncertainties. Meanwhile, a relatively little progress has been made on the inclusion of the resilience aspects into the planning process of a dry ports construction that would instruct the capacity planner, on how to mitigate the occurrence of disruptions that may lead to million dollars of losses due to the deviation of the future cash flows from the expected financial flows on the project. The current experience shows that the existing methodological base is developed fragmentary within separate steps of supply chain risk management (SCRM) processes: risk identification, risk evaluation, risk mitigation, risk monitoring and control phases. The lack of the systematic approach hinders the solution of the problem of risk management processes of dry port implementation. Therefore, management of various risks during the investments phases of dry port projects still presents a considerable challenge from the practical and theoretical points of view. In this regard, the given research became a logical continuation of fundamental research, existing in the financial models and theories (e.g., capital asset pricing model and real option theory), as well as provided a complementation for the portfolio theory. The goal of the current study is in the design of methods and models for the facilitation of dry port implementation through the mechanism of public-private partnership on the national market that implies the necessity to mitigate, first and foremost, the shortage of the investments and consequences of risks. The problem of the research was formulated on the ground of the identified contradictions. They rose as a continuation of the trade-off between the opportunities that the investors can gain from the development of terminal business in Russia (i.e. dry port implementation) and risks. As a rule, the higher the investment risk, the greater should be their expected return. However, investors have a different tolerance for the risks. That is why it would be advisable to find an optimum investment. In the given study, the optimum relates to the search for the efficient portfolio, which can provide satisfaction to the investor, depending on its degree of risk aversion. There are many theories and methods in finance, concerning investment choices. Nevertheless, the appropriateness and effectiveness of particular methods should be considered with the allowance of the specifics of the investment projects. For example, the investments in dry ports imply not only the lump sum of financial inflows, but also the long-term payback periods. As a result, capital intensity and longevity of their construction determine the necessity from investors to ensure the return on investment (profitability), along with the rapid return on investment (liquidity), without precluding the fact that the stochastic nature of the project environment is hardly described by the formula-based approach. The current theoretical base for the economic appraisals of the dry port projects more often perceives net present value (NPV) as a technique superior to other decision-making criteria. For example, the portfolio theory, which considers different risk preference of an investor and structures of utility, defines net present value as a better criterion of project appraisal than discounted payback period (DPP). Meanwhile, in business practice, the DPP is more popular. Knowing that the NPV is based on the assumptions of certainty of project life, it cannot be an accurate appraisal approach alone to determine whether or not the project should be accepted for the approval in the environment that is not without of uncertainties. In order to reflect the period or the project’s useful life that is exposed to risks due to changes in political, operational, and financial factors, the second capital budgeting criterion – discounted payback period is profoundly important, particularly for the Russian environment. Those statements represent contradictions that exist in the theory and practice of the applied science. Therefore, it would be desirable to relax the assumptions of portfolio theory and regard DPP as not fewer relevant appraisal approach for the assessment of the investment and risk measure. At the same time, the rationality of the use of both project performance criteria depends on the methods and models, with the help of which these appraisal approaches are calculated in feasibility studies. The deterministic methods cannot ensure the required precision of the results, while the stochastic models guarantee the sufficient level of the accuracy and reliability of the obtained results, providing that the risks are properly identified, evaluated, and mitigated. Otherwise, the project performance indicators may not be confirmed during the phase of project realization. For instance, the economic and political instability can result in the undoing of hard-earned gains, leading to the need for the attraction of the additional finances for the project. The sources of the alternative investments, as well as supportive mitigation strategies, can be studied during the initial phases of project development. During this period, the effectiveness of the investments undertakings can also be improved by the inclusion of the various investors, e.g. Russian Railways’ enterprises and other private companies in the dry port projects. However, the evaluation of the effectiveness of the participation of different investors in the project lack the methods and models that would permit doing the particular feasibility study, foreseeing the quantitative characteristics of risks and their mitigation strategies, which can meet the tolerance of the investors to the risks. For this reason, the research proposes a combination of Monte Carlo method, discounted cash flow technique, the theory of real options, and portfolio theory via a system dynamics simulation approach. The use of this methodology allows for comprehensive risk management process of dry port development to cover all aspects of risk identification, risk evaluation, risk mitigation, risk monitoring, and control phases. A designed system dynamics model can be recommended for the decision-makers on the dry port projects that are financed via a public-private partnership. It permits investors to make a decision appraisal based on random variables of net present value and discounted payback period, depending on different risks factors, e.g. revenue risks, land acquisition risks, traffic volume risks, construction hazards, and political risks. In this case, the statistical mean is used for the explication of the expected value of the DPP and NPV; the standard deviation is proposed as a characteristic of risks, while the elasticity coefficient is applied for rating of risks. Additionally, the risk of failure of project investments and guaranteed recoupment of capital investment can be considered with the help of the model. On the whole, the application of these modern methods of simulation creates preconditions for the controlling of the process of dry port development, i.e. making managerial changes and identifying the most stable parameters that contribute to the optimal alternative scenarios of the project realization in the uncertain environment. System dynamics model allows analyzing the interactions in the most complex mechanism of risk management process of the dry ports development and making proposals for the improvement of the effectiveness of the investments via an estimation of different risk management strategies. For the comparison and ranking of these alternatives in their order of preference to the investor, the proposed indicators of the efficiency of the investments, concerning the NPV, DPP, and coefficient of variation, can be used. Thus, rational investors, who averse to taking increased risks unless they are compensated by the commensurate increase in the expected utility of a risky prospect of dry port development, can be guided by the deduced marginal utility of investments. It is computed on the ground of the results from the system dynamics model. In conclusion, the outlined theoretical and practical implications for the management of risks, which are the key characteristics of public-private partnerships, can help analysts and planning managers in budget decision-making, substantially alleviating the effect from various risks and avoiding unnecessary cost overruns in dry port projects.

Brändin vahvistaminen ja uudistaminen kiinteistönvälitysalalla

Tutkimus keskittyy brändin luomiseen ja brändin kokonaisvaltaisen hallinnan keinoihin kiinteistönvälitysalalla. Tutkielman tavoitteena on selvittää miten yritykset hyödyntävät brändipääomiaan brändiä vahvistettaessa ja uudistettaessa. Tätä kysymystä pyritään tarkastelemaan erityisesti kahden case-yhtiön näkökulmasta, jotka molemmat toimivat kiinteistönvälitysalalla. Tutkimuksen pääongelmaksi muodostui kysymys: ”Mitä tekijöitä tulisi huomioida brändipääoman vahvistamisessa ja uudistamisessa kiinteistönvälitysalalla toimivissa yrityksissä?”. Tutkimus on luonteeltaan laadullinen eli kvalitatiivinen tutkimus. Laadullinen tutkimus pohjaa läheisesti teorian ja empirian väliseen vuorovaikutukseen ja sen lähtökohtana on pyrkiä kuvaamaan tutkimuskysymystä kokonaisvaltaisesti. Laadullisen tutkimuksen tarkoituksena on myös löytää tai tuoda esille tosiasioita sen sijaan, että todennettaisiin jo olemassa olevia väittämiä (Hirsijärvi, Remes & Sajavaara 2000, 152). Tutkimusmetodina aineiston keräämisessä käytettiin tutkimushaastattelua, joka toteutettiin tapaustutkimuksena. Tapaustutkimukselle tyypillisesti haastattelu oli puolistrukturoitu, joten haastateltavat vastasivat tutkijan esittämiin kysymyksiin, jotka olivat samat molemmille haastateltaville, mutta keskustelua ei rajoitettu. Huoneistokeskuksen edustajan mukaan brändejä pitää tarpeen tullen uudistaa, mutta se ei saa olla itsetarkoituksena. Mikäli brändi on brändijohtaja alallaan, ei suuria muutoksia kannata lähteä tekemään vain tekemisen vuoksi, vaan niille pitää olla jokin selvä tarkoitus. Brändin viestin vahvistaminen onkin brändijohtajana toimivalle yritykselle usein parempi ratkaisu, kuin toimivan konseptin uudistaminen. Huoneistokeskus pyrkiikin varmistamaan sen, että brändin viesti ei pääse unohtumaan asiakkailta. Huom!:in liiketoimintajohtajan mukaan brändiä uudistettaessa on tärkeää, että brändiä konkreettisesti muutetaan. Huom! onkin tästä syystä positioinut itsensä aikaisemmasta poiketen edelläkävijäksi pitkäikäisyyden painottamisen sijaan. Huom! on myös painottanut entistä enemmän laadukkuuttaan ja avoimuuttaan ja nämä pyritään osoittamaan verkkosivujen asiakasarvosteluilla. Johtopäätöksenä voidaan todeta, että molemmat yritykset pitävät kaikkia brändipääomatekijöitä tärkeinä kiinteistönvälitysalalla. Tästä huolimatta brändiä vahvistettaessa Huoneistokeskuksen edustaja oli sitä mieltä, että tärkeintä on keskittyä brändin tunnettuuteen. Huom!:in edustaja sen sijaan oli sitä mieltä, että brändiä uudistettaessa tärkeintä on keskittyä laadun tuottamiseen ja yhdistämään tämä myös mielleyhtymäksi. Haastateltavia oli kuitenkin vain kaksi, joten tutkimuksen johtopäätöksiä ei voida yleistää koskemaan koko toimialaa.

Exploring knowledge worker motivation in autonomous and interdependent problem solving tasks on virtual platforms

The objective of this study is to understand why virtual knowledge workers conduct autonomous tasks and interdependent problem solving tasks on virtual platforms. The study is qualitative case study including three case organizations that tap the knowledge of expert networks, and utilize virtual platforms in the work processes. Research data includes 15 interviews, that is, five experts from each case company. According to the findings there are some specific characteristics in motivation to work on tasks on online platforms. Autonomy, self-improvement, meaningful tasks, knowledge sharing, time management, variety of contacts, and variety of tasks, and projects motivate virtual knowledge workers. Factors that may enhance individuals’ engagement to work on tasks are trust, security of continuous task flow and income, feedback, meaningful tasks and tasks that contribute to self-improvement, flexibility and effectiveness in time management, and virtual tools that support social interaction. The results also indicate that there are some differences in individuals’ motivation based on the tasks’ nature. That is, knowledge sharing and variety of contacts motivated experts who worked on interdependent problem solving tasks. Then again, autonomy and variety of tasks motivated experts who worked on autonomous tasks.

Efficient Algorithms for Coastal Geographic Problems

The increasing performance of computers has made it possible to solve algorithmically problems for which manual and possibly inaccurate methods have been previously used. Nevertheless, one must still pay attention to the performance of an algorithm if huge datasets are used or if the problem iscomputationally difficult. Two geographic problems are studied in the articles included in this thesis. In the first problem the goal is to determine distances from points, called study points, to shorelines in predefined directions. Together with other in-formation, mainly related to wind, these distances can be used to estimate wave exposure at different areas. In the second problem the input consists of a set of sites where water quality observations have been made and of the results of the measurements at the different sites. The goal is to select a subset of the observational sites in such a manner that water quality is still measured in a sufficient accuracy when monitoring at the other sites is stopped to reduce economic cost. Most of the thesis concentrates on the first problem, known as the fetch length problem. The main challenge is that the two-dimensional map is represented as a set of polygons with millions of vertices in total and the distances may also be computed for millions of study points in several directions. Efficient algorithms are developed for the problem, one of them approximate and the others exact except for rounding errors. The solutions also differ in that three of them are targeted for serial operation or for a small number of CPU cores whereas one, together with its further developments, is suitable also for parallel machines such as GPUs.