Bry sig om : ett vårdvetenskapligt praxisbegrepp

’Bry sig om’ förekommer flitigt i sammanhang där människor vårdar och tar hand om varandra såväl i det vardagliga naturliga vårdandet som i det professionella vårdandet. ’Bry sig om’ är ett språkligt uttryck i människors vardagsspråk som hör samman med ’små vardagliga saker’ som är av betydelse. ’Bry sig om’ har även tydlig förbindelse med vårda och ansa i Erikssons caritativa vårdteori men har inte tidigare varit föremål för klinisk vårdvetenskaplig forskning vilket är bakgrunden till denna studie. Inom Erikssons caritativa vårdteori utgörs grundordningen av kärnbegreppen caritas, enheten människa, hälsa, lidande och vårdande. I den här avhandlingen är syftet att vidga förståelsen för kärnbegreppet vårdandet genom att utforska innebörden i praxisbegreppet ’bry sig om’. Studien har en hermeneutisk ansats och är en sammanläggningsavhandling med fyra delstudier i form av begreppsanalys och tre empiriska studier. Materialet i begreppsutredningen är etymologisk ordbok och svenska ordböcker. I de empiriska delstudierna består materialet av självbiografisk text skrivet av en patient och händelser som patienter och vårdare varit med om vilket förstås som betydelsefullt material för klinisk vårdvetenskaplig forskning. Den nya förståelsen gestaltas i ett tankemönster där ’bry sig om’ framträder som en inre etisk hållning där människan som är på plats kan finnas till och därmed betyda något för en annan människa. Att betyda något för en annan människa är uttryck för det naturliga omsorgsfulla vårdandet där patienten förnimmer en kärleksfull hållning i vårdarens varsamma kärleksfulla händer och varma röst. ’Bry sig om’, har sin grundval i det naturliga omsorgsfulla vårdandet som konstituerar människan som människa. Det som framkommit i avhandlingen är möjligheten att undersöka praxisbegrepp inom vårdvetenskapen där ’bry sig om’ bidragit till att synliggöra vårdandet och därmed innebörden och meningen i ansandet, lekandet och lärandet på ett nytt och annorlunda sätt ur ett kliniskt vårdvetenskapligt perspektiv.

Vauhtikausi. Autoilun sukupuoli 1920-luvun Suomessa

The Age of Speed:Automobility’s Gender in the 1920s Finland The aim of this study is to analyze the connections between automobility and gender in Finland in the 1920s. In this study it is argued that the 1920s was the significant era in the Finnish history of automobility when many of the long-lasting gendered notions and cultural understandings were constructed. This study combines cultural history of technology with gender analysis. As the previous research on gender and technology has recognized, technology is a significant site of gender negotiations. Both from the cultural historical perspective and a gender perspective it is important to understand both technology and gender as cultural constructions. They were linked together and constructed each other. In other words: technology shapes gender and gender shapes technology. Historians of technology like Nina Lerman, Ruth Oldenziel and Arwen Mohun have argued that both gender and technology are about power: social, cultural, economic and political. In this study automobility means technology that can be analyzed in layers of identity, structures, institutions and representations. The source material consists of various types of historical sources, magazines and journals, advertisements, archival material together with films and literature. In the previous studies of the history of automobility gender has often been neglected. The term “gender” has also quite often been misunderstood. Some studies in the field have only focused on the early female drivers. However, far too little attention has been paid to the question, why automobility was considered as masculine sphere only. This study aims to give new insights to the previous interpretations of the history of automobility. As in various other countries also in Finland, the decade of the 1920s is characterized as a period of “modern times.” It was also the era of the automobiles. Although the number of cars in Finland was still low compared to the other European countries and the USA, in press, films and literature, images of automobiles and new women – and men – on the wheel became as an emblem of a new era. The thesis consists of three main chapters. The first main chapter focuses on the conflicts between drivers and non-drivers. The study shows how in the debate of the automobility “a driver” was constantly referred as a man and “a pedestrian” accordingly a woman, even though in the reality there were as much men and women walking on the streets and the roads. Thus, the public debate constructed and reconstructed the gendered traffic system where men were playing the key role. The second main chapter of the study analyses the automobile clubs and the cultural representations. The chapter answers the question how the concept of a driver was gendered. The Automobile clubs and the organizations of professional drivers were in a significant role in developing the early history of traffic in Finland. The Finnish Automobile Club (Suomen Automobiili Klubi, founded in 1919) was the oldest and the most powerful of all automobile organizations. The Finnish Automobile Club accepted women as members from the very beginning. The membership was strictly limited to the upper class and the very first female members were wives and daughters of the male members. However, Doctor of medicine and surgery 316 Karolina Eskelin (1867-1936) the founding member of the Club was an exception to that convention. The male members of the Finnish Automobile Club attended official international meetings and consulted Finnish authorities in traffic and road questions, whereas, female members joined car trips, picnics and social gatherings arranged by the club. Few young female members of the club drove in races and gross-country-tours. The cultural representations of drivers in the Finnish media in the 1920s both deconstructed and reconstructed the concept of gender. In Finnish press in general, motoring was seen as male dominated area. Men were represented as the experts of the automobility. The drivers’ uniforms and the automobile clubs underlined professionalism and expertise which, thus, got masculine meaning. Women were beautiful accessories in the car ads, but they were also becoming a new consumer group in the market. The representations of the female and the male drivers influenced and shaped actively the understandings of femininity and masculinity. In the third main chapter the analysis focuses on the automobile as an artifact.The automobile was considered as an artifact that primarily belonged to the masculine domain. However, the representations of the automobiles were ambivalent. The automobile was both masculine and feminine depending on the context. The representations of the automobile were also used to construct the discourse of heteronormativity.

The effects of the service process on satisfaction, trust and value as creators of customer loyalty in a daily deals concept

This study aims at applying the customer behaviour studies of satisfaction, trust, perceived value and loyalty to a daily deals concept. The goal is to find out whether the relationships are the same in this specific context when compared to previous e-commerce studies. The study examines how the daily deals service process affects customer satisfaction, trust and value, and how these in turn impact customer loyalty and each other. The data was collected via e-mail survey from case company customers, and research was conducted on a quantitative basis by using multivariate methods as tools. The results suggest that daily deals service process and service quality do have a direct and positive effect on customer satisfac-tion, trust and value. Additionally, positive correlations between the latter variables and customer loyalty were found. The results imply that the daily deals concept does not differ from other e-services when considering the studied factors. The results also emphasize the importance of recognizing what determinants have the greatest impact on customer loyalty in this specific context.

Power-line-communication-based data transmission concept for an LVDC electricity distribution network – Analysis and implementation

Communications play a key role in modern smart grids. New functionalities that make the grids ‘smart’ require the communication network to function properly. Data transmission between intelligent electric devices (IEDs) in the rectifier and the customer-end inverters (CEIs) used for power conversion is also required in the smart grid concept of the low-voltage direct current (LVDC) distribution network. Smart grid applications, such as smart metering, demand side management (DSM), and grid protection applied with communications are all installed in the LVDC system. Thus, besides remote connection to the databases of the grid operators, a local communication network in the LVDC network is needed. One solution applied to implement the communication medium in power distribution grids is power line communication (PLC). There are power cables in the distribution grids, and hence, they may be applied as a communication channel for the distribution-level data. This doctoral thesis proposes an IP-based high-frequency (HF) band PLC data transmission concept for the LVDC network. A general method to implement the Ethernet-based PLC concept between the public distribution rectifier and the customerend inverters in the LVDC grid is introduced. Low-voltage cables are studied as the communication channel in the frequency band of 100 kHz–30 MHz. The communication channel characteristics and the noise in the channel are described. All individual components in the channel are presented in detail, and a channel model, comprising models for each channel component is developed and verified by measurements. The channel noise is also studied by measurements. Theoretical signalto- noise ratio (SNR) and channel capacity analyses and practical data transmission tests are carried out to evaluate the applicability of the PLC concept against the requirements set by the smart grid applications in the LVDC system. The main results concerning the applicability of the PLC concept and its limitations are presented, and suggestion for future research proposed.

University Image vs. University Identity: Congruence between Expectations and Experience

The aim of this thesis was to examine congruencies between university identity and university images of prospective and current students. Therefore, factors essentially influencing on expected and experienced university images were identified. Providing an understanding on the differences in the formation of both concepts allowed the analysis of potential incongruities between a university’s identity and the perceptions its students hold. The study was conducted in July and August 2013 at Lappeenranta University of Technology by means of a web-based research survey. The sample consisted of 160 international Master’s degree students who were admitted in 2011, 2012 and 2013. Descriptive and multivariate statistical analysis methods were used to process the data. The results of the study indicated statistically significant incongruities between the case university’s identity and its students’ images. Further, the expected and experienced university images showed incongruities to each other. Deviations were additionally detected to be dependent on the students’ home regions. All in all, there is potential for an improvement of the students’ experiences resulting from a low perception of the student’s preparation for future job life.

Brand Identity and Image in B2B Factory Automation Context

The goal of this thesis is to study how a solution-oriented business-to-business company can utilize its brand as a strategic asset by using the concepts of brand identity and brand image. The study analyses the intended brand message (identity) contrasting it with the customer perceptions (image) to reveal points of parity and congruence. The study uses a case company as an example and discusses the benefits of brand management as well. Internally, brands can be studied by performing a set of interviews amongst top and middle management. The interviews need to consider the various elements of branding from associations to differentiation and value creation. Customers’ perceptions can be reliably studied via online survey designed to compare the intended brand message with customers’ experiences. From the perspective of industrial management the incentive for brand development lies in both monetary and managerial benefits. In literature the four essential benefits of B2B branding are risk dilution, efficiency of communications, strategic direction and price premiums. As a result, suggestive models for brand identity and image were devised and compared. The Case Company perceives itself as a technically oriented open-integrator, with a strong focus on reliability and customer service. Customers agree with the picture in general, but there are some points of parity as well: they are quite satisfied with the company and perceive it as reliable and providing the promised value. The problematic areas revolve around customer interaction and maintaining the leadership position. The results confirm previous findings in B2B branding theory, where the reliability and credibility of the supplier are in major role. The results also suggest a holistic, corporate approach on branding.

Serva ad ministrare : tjänandets ethos i vårdledarskap

Avhandlingen syftar till att ur ett vårdvetenskapligt perspektiv beskriva och upptäcka tjänandets meningsinnehåll samt fördjupa förståelsekunskap om tjänandets ethos i förhållande till vårdledarskap med en inriktning på det vårdadministrativa. Syftet är även att skapa en idealmodell som öppnar för en ny eller annorlunda förståelsehorisont för tjänandets ethos i vårdledarskap. Kunskapssökandet sker genom följande delstudier: (1) I begreppsbestämningen genomförs begreppsanalyser av tjäna och tjänst med avsikt att öppna för en grundförståelse och tankestruktur i forskningsuppgiften. (2) I det idéhistoriska spåras tjänandets ontologiska arv och idémönster fram genom tolkning av historiska källornas texter från 1900-talets första hälft i ljuset av sjuksköterskeledarskap utgående från Sophie Mannerheims, Bertha Wellins och Bergljot Larssons idéer och tankeströmningar. (3) Sökandet fortsätter i dagens kliniska kontextbas genom kvalitativa djupintervjuer med 30 deltagare (vårdledare och vårdare) från Finland, Sverige och Norge. Förförståelsen och forskningens teoretiska perspektiv har rötter i Erikssons caring science-tradition och vårdvetenskapens ontologiska grundantaganden som utvecklats vid Åbo Akademi, Enheten för vårdvetenskap i Vasa. Forskningsansatsen är inspirerad av H-G Gadamers filosofiska hermeneutik. Designen är explorativ-deskriptiv, idiografisk och implicerar ett hypotetisk-deduktivt tillvägagångssätt. Tjänandet och vårdledarskapets ethos upptäcks och tolkas genom det metodologiska närmandet: Erikssons hermeneutiska begreppsbestämningsmodell, idéhistoriska läsakt och hermeneutiska läsakt. Materialet bildar förståelsehorisonter genom den hermeneutiska dialogens successiva och oändliga rörelse. Horisonterna reflekteras mot teorikärnan för att öppna för ny förståelse av tjänandets meningsinnehåll, vårdledarskap och vårdadministration. I slutandet sker en horisontsammansmältning och en reflektiv anslutning till vårdvetenskapens teorikärna som visar hur tjänandets ethos blir evident i vårdledarskap. Resultatet visar att vårdledarskap som är tjänande för patienten och vårdkulturen synliggörs i vårdadministrationens kontext genom huvudets skärpa, handens gärningar och hjärtats visdom. Tjänandets sanna, goda och sköna tidlösa rörelse är riktad mot hälsa och helande. I dag sammankopplas tjänande inom vårdorganisationer med hälsoekonomiska förhållanden, effektivitet, produktivitet och rationalitet, vilket strider mot tjänandets värdegrund, människans värdighet och respekt för livet. Vårdorganisationernas etiska ansvar är att fungera som samhälleliga förebilder, tillrättalägga för vårdadministrationernas tjänande och stå i patientens tjänst. Gestaltningen av tjänandets ethos i vårdledarskap öppnar för nya diskurser, riktningar, visioner och handlingar i den vårdadministrativa verkligheten. Avhandlingen ger vårdvetenskapens systematiska grundforskning ett teoritillskott av fördjupad förståelse av tjänandets och vårdledarskapets historiska och samtida ontologiska evidens och ethos med applikationen på klinisk vårdvetenskap.

Interpreting marine benthic ecosystem functioning in coastal waters: validating the biological trait concept

Coastal areas harbour high biodiversity, but are simultaneously affected by rapid degradations of species and habitats due to human interactions. Such alterations also affect the functioning of the ecosystem, which is primarily governed by the characteristics or traits expressed by the organisms present. Marine benthic fauna is nvolved in numerous functions such as organic matter transformation and transport, secondary production, oxygen transport as well as nutrient cycling. Approaches utilising the variety of faunal traits to assess benthic community functioning have rapidly increased and shown the need for further development of the concept. In this thesis, I applied biological trait analysis that allows for assessments of a multitude of categorical traits and thus evaluation of multiple functional aspects simultaneously. I determined the functional trait structure, diversity and variability of coastal zoobenthic communities in the Baltic Sea. The measures were related to recruitment processes, habitat heterogeneity, large-scale environmental and taxonomic gradients as well as anthropogenic impacts. The studies comprised spatial scales from metres to thousands of kilometres, and temporal scales spanning one season as well as a decade. The benthic functional structure was found to vary within and between seagrass landscape microhabitats and four different habitats within a coastal bay, in papers I and II respectively. Expressions of trait categories varied within habitats, while the density of individuals was found to drive the functional differences between habitats. The findings in paper III unveiled high trait richness of Finnish coastal benthos (25 traits and 102 cateogries) although this differed between areas high and low in salinity and human pressure. In paper IV, the natural reduction in taxonomic richness across the Baltic Sea led to an overall reduction in function. However, functional richness in terms of number of trait categories remained comparatively high at low taxon richness. Changes in number of taxa within trait categories were also subtle and some individual categories were maintained or even increased. The temporal analysis in papers I and III highlighted generalities in trait expressions and dominant trait categories in a seagrass landscape as well as a “type organism” for the northern Baltic Sea. Some initial findings were made in all four papers on the role of common and rare species and traits for benthic community functioning. The findings show that common and rare species may not always express the same trait categories in relation to each other. Rare species in general did not express unique functional properties. In order to advance the understanding of the approach, I also assessed some issues concerning the limitations of the concept. This was conducted by evaluating the link between trait category and taxonomic richness using especially univariate measures. My results also show the need to collaborate nationally and internationally on safeguarding the utility of taxonomic and trait data. The findings also highlight the importance of including functional trait information into current efforts in marine spatial planning and biomonitoring.

Leveraging National Federated Identity Services

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

AQUAREL CONCEPT Aquatic resources for green energy realization

The AQUAREL project studied the availability and optional utilization methods for fish processing side streams and other aquatic biomaterial in the Republic of Karelia. Additionally processing aquatic biomaterial with manure and sewage sludge was studied. Based on the results, the most feasible option today is to process fish side streams to fish oil and dewatered oil-free residue and to use them for fish or animal feed production. However, it is necessary to highlight, that changes in e.g. economic environment, energy prices and demand may require re-evaluating the results and conclusions made in the project. Producing fish oil from fish processing side streams is an easy and relatively simple production process generating a valuable end product. The functionality of the process was confirmed in a pilot conducted in the project. The oil and solids are separated from the heated fish waste based on gravity. The fish oil separating on top of the separator unit is removed. Fish oil can as such be utilized for heating purposes, fish meal or animal feed production, but it can also be further processed to biodiesel. However, due to currently moderate energy prices in Russia, biodiesel production is not economically profitable. Even if the fish oil production process is not complicated, the operative management of small-scale fish oil production unit requires dedicated resources and separate facilities especially to meet hygiene requirements. Managing the side streams is not a core business for fish farmers. Efficient and economically profitable fish oil production requires a centralized production unit with bigger processing capacity. One fish processing unit needs to be designed to manage side streams collected from several fish farms. The optimum location for the processing unit is in the middle of the fish farms. Based on the transportation cost analysis in the Republic of Karelia, it is not economically efficient to transport bio-wastes for more than 100 km since the transportation costs start increasing substantially. Another issue to be considered is that collection of side streams, including the dead fish, from the fish farms should be organized on a daily basis in order to eliminate the need for storing the side streams at the farms. Based on AQUAREL project studies there are different public funding sources available for supporting and enabling profitable and environmentally sustainable utilization, research or development of fish processing side streams and other aquatic biomaterial. Different funding programmes can be utilized by companies, research organizations, authorities and non-governmental organizations.

Kjærlighet i forbundethet : en kraft i gamle menneskers åndelighet og verdighet

The thesis is rooted in caring science and the notion that the human being is an indivisible unity of body, soul and spirit. The purpose is to search for new, or expanded knowledge and understanding of the substance of the human’s spiritual space, as well as aspects that may constitute a foundation for the safeguard of human dignity. The clinical research study concerns the importance of spirituality and dignity in the care for older people. The thesis consists of three substudies with four articles, and the methodology is based on Gadamer’s philosophical hermeneutics. Through a metasynthesis of 17 research articles, sub-study I searched for understanding of the concept of spirituality as it may appear in reality (deduction). 17 older people were interviewed in sub-study II. This sub-study sought understanding for spirituality and dignity in the specific reality (induction). Sub-study III searched for theory development regarding spirituality, through a literature review of 20 research articles and a text by Tillich (abduction). The findings imply that spirituality entails human beings’ connectedness with one’s inner space and connectedness beyond oneself. Love in connectedness appears as a force in both spirituality and dignity. Themes portrayed include understanding of the spiritual space, religiousness, dignity, and spiritual care. The relationship between dignity and spirituality can be seen in the confirmation of human worth and care for the whole human being, including the spiritual dimension, and this is understood as a prerequisite for perceived dignity. It seems to be important that older people feel valued, loved, not abandoned, and alive. The theoretical model portrays love as a reunifying and connecting force that may foster confirmation, serving, longing and holiness. The movement towards connectedness may create room for the human being’s perception of dignity and holiness, and as such, it may be a force in the search for wholeness and becoming in health.

Kallet til livets embete : mødre i helse og lidelse

Mothers represent the natural caring. Natural caring is the object of caring science and of research interest because it establishes the central core of professional caring. In this study, we encounter patients who are mothers in need of care in a psychiatric context. Motherhood involves taking responsibility that extends beyond one's own life, because the child represents possibilities in a yet unknown future. Understanding and knowledge about the mothers' struggle in health and suffering are of crucial importance to enable clinical practice to make provisions for and adapt to the individual patient. The overall purpose of this dissertation is to illuminate how the innermost essence of caring emerges in health and suffering in patients who are mothers in psychiatric care. The purpose of the study in a clinical sense is to seek to understand and illuminate the patient's inner world in health and suffering in terms of contextual, existential, ontological and ethical dimensions. The dissertation is exploratory and descriptive in nature and encompasses induction, deduction and abduction as logics tools of reasoning. A theoretical model of natural caring and a universal theoretical model of the innermost essence of caring is developed as seen from the patient's world in a psychiatric context. The dissertation is anchored in human science's view of the human being and the world and in caring science's perspective. Caring science's view of the human being as a unity comprising body, soul and spirit is central in the study's concept of the patient. This multi-dimensional conception of the human being encompasses the dissertation's basic values and is decisive for choice of methodology. Hermeneutic epistemology guided the interpretation of the empirical data, the paradigmatic theses and assumptions. The dialectical movement in interpretation moves back and forth between empirical data, caring science theory and philosophical theory and reveals deeper insight into meaningful content in the clinical context. The interpretation process comprises four levels of abstraction: rational, contextual, existential and ontological. Hermeneutic philosophy guides the inductive and deductive approach to interpretation, as well as the movement between the clinical context and the caring science paradigm. In this encounter between the visible and invisible reality, the image of natural caring – motherliness emerged. The dissertation consists of four studies. The first study is a systematic review of nineteen research articles. The three other studies are hermeneutical interpretations based on text materials from open interviews. Fifteen participants were interviewed, all of whom are mothers of children between 0 and 18 years of age. All were outpatients in the psychiatric specialist health service. In the interpretation process, the mothers' struggle in health and suffering emerges as a struggle between the inner and outer world. Being a mother and patient in health and suffering in a psychiatric context means to struggle to be oneself, to create oneself, to live and realize one's good deeds as a mother and human being. To be oneself, to possess oneself as a mother is not only a question of tending, playing and learning in order to master a practical situation or to survive. It involves constituting a deep, inner desire to courageously create oneself so that the child is able to realize his or her potential in health and suffering. Motherliness manifests itself in caring as a call to ministering humanity and life. The voice of motherliness is understood as the voice of life—the eternal, inner call of love and freedom. The inner call craves fulfilment. Motherliness in natural caring does not retreat. Motherliness defines the Other as freedom and proceeds without regard for all other exterior requirements to realizing wellbeing. The inner essence of caring is attentive, aware and heeds the call of the heart. The innermost essence of caring is to be and to make oneself responsible for the Other. Responsibility cannot be relinquished; free choice consists in whether or not to follow the call. To renounce the inner call to responsibility is to deny oneself and one's dignity as a human being. The theoretical models provide clinical and systematic caring science with knowledge and understanding based on the natural caring spirit inherent in the human being. The study elucidates and strengthens the ontological basic assumptions about the human being as a unity of body, soul and spirit, the sanctity of the human being and the core of caring, ethos. The results of the dissertation will provide clinical practice with knowledge about the inner movements of the mothers' souls in relation to their responsibility as mothers and human beings. Being able to understand the basic conditions for responsibility is crucial for developing care that encompasses mother and child and the mutual relationship between them. This is basic knowledge for developing attitudes and actions that meet and provide for the needs of the patient as mother and as a whole, suffering human being.

Urvilja : när livet är människans hem

This caring science study explores ‘Will’ as an ontological concept. The aim is to deepen the understanding of the essence of Will, and to highlight the manifestations of Will and how Will becomes evident in clinical caring. Will is ontological and universal. Will is connected with the essence of the human being, and manifests in the human being as will. The approach is inspired by Gadamer’s philosophical hermeneutics. The study’s horizon of understanding consists of Eriksson’s caritative theory and the caring science-tradition. The study’s research questions are as follows: What is the essence of Will? What are its manifestations? How does Will become evident in clinical caring? The hermeneutic interpretative movement is initiated by the material, which consists of the philosopher Arthur Schopenhauer’s texts, letters from experts and dictionaries. Meaning-bearing substance fragments in the material are intertwined with the original horizon of understanding through hermeneutical reading, hermeneutical interpretation and concept analysis in an oscillating interpretive movement. An abstraction occurs when the new substance is illuminated by the caring science ontology. The oscillating interpretive movement results in a reinterpreted horizon of understanding, which in turn provides the findings of the study. The reinterpreted horizon of understanding is presented in the form of a theoretical model and abductive theses. The essence of Will is represented in the theoretical model as the lifeaffirming and the loving force. Life and love are Will’s origin and destination. Will’s manifestations (its diversity) hold conditions and chance occurrences that obstruct Will. Hence the will of the human being does not necessarily appear in a way that is in tune with ontological Will. Will represents the lifeblood of ethos, and in this lifeblood love flows. Will acts by virtue of itself, and gives ethos its force. Will manifests in a way that ethos can affirm. When Will is affected by caring its force is active in the service of life and love. Being a caregiver entails acting as a world-eye, which means recognizing Will in diversity. For caregivers, being a world-eye means observing fragments of Will as it manifests in its original form in the real reality, and acting as the mirror of life. The human being who is able to perceive the fundamental values of life and to live according to these has understood the laws of life and entered upon the human calling. The human being then lives according to the fundamental order and has found a home in life.