Sairaanhoitajaopiskelijoiden ohjattujen käytännön harjoittelujen aikana ilmenneet eettiset ongelmat

Ethical problems occurring during the practical training period of Finnish nursing students The present study focused on nursing students adopting the professional code of conduct during their supervised practical training. The study was carried out in two phases. During the first phase, the objective was to survey ethical problems occurring in practical training as well as how these problems are detected and resolved by nursing students and their supervisors at different stages of their studies. In the second phase, the capability of the nursing students about to graduate to detect and resolve ethical problems was described and analyzed. The students’ capacity for self-instruction, independent search for information as well as factors related to teaching of ethics were determined within this phase. Further, an extensive literature review was carried out to complement the study. Thus, the main objective of the thesis was to make suggestions for the development of the teaching of ethics and supervision in nursing studies and in practice. In the first part of the empirical phase (2002–2005), the views of the nursing students (n =18) were clarified with themed open essay questions. Furthermore, the views of the supervising nurses (n = 115) were established by utilizing a series of themed questions and group interviews. During the second phase (2006–2007), the data for the analyses were collected from nursing students in their graduating stage (n = 319) by a national Internet-based questionnaire. The results of the first phase were examined with contentanalysis and those of the second phase both statistically and by using content analysis. Ethical problems occurring during supervised practical training were typically connected to a patient or a client, a member of the nursing staff or to a student, while solutions were connected to preparation and the action to solve the problem in question. Ethical dilemmas were classified as legal, ethical comportment and uncertainty problems as well as personal and institutional ones. The solutions for these problems were further grouped as based on facts, instructor/staff/member/specialist or patient/client/relative. The results showed that although the nursing students about to graduate had detected many ethical problems both independently as well as together with the nursing staff during every practical training period, they were able to resolve only few of them. Ethical problems were most frequently encountered during training in psychiatric nursing. On the grounds of their own impressions, the nursing students stated that their ability to detect and solve ethical problems improved during their training period. The primary factors related to this enhancement of their skills were teaching and the students’ readiness for selfinstruction. Gender, orientation of the studies and age were observed to be the most important among the underlying factors influencing the capability to detect and solve ethical problems as well as to engage in self-instruction. Based on the results obtained, suggestions for development as well as topics for further studies are presented through teaching of professional ethics and supervision during practical training.

Customer reference marketing in a business to business context

This study focuses on the phenomenon of customer reference marketing in a business tobusiness (B to B) context. Although customer references are generally considered an important marketing and sales tool, the academic literature has paid surprisingly little attention to the phenomenon. The study suggests that customer references could be viewed as important marketing assets for industrial suppliers, and the ability to build, manage and leverage customer reference portfolios systematically constitutes a relevant marketing capability. The role of customer references is examined in the context of the industrial suppliers' shift towards a solution and project orientation and in the light of the on going changes in the project business. Suppliers in several industry sectors are undergoing a change from traditional equipment manufacturing towards project and solution oriented business. It is argued in this thesis that the high complexity, the project oriented nature and the intangible service elements that characterise many contemporary B to B offerings further increase the role of customer references. The study proposes three mechanisms of customer reference marketing: status transfer, validation through testimonials and the demonstration of experience and prior performance. The study was conducted in the context of Finnish B to B process technology and information technology companies. The empirical data comprises 38 interviews with managers of four case companies, 165 customer reference descriptions gathered from six case companies' Web sites, as well as company internal material. The findings from the case studies show that customer references have various external and internal functions that contribute to the growth and performance of B to B firms. Externally, customer references bring status transfer effects from reputable customers, concretise and demonstrate complex solutions, and provide indirect evidence of experience, previous performance, technological functionality and delivered customer value. They can also be leveraged internally to facilitate organisational learning and training, advance offering development, and motivate personnel. Major reference projects create new business opportunities and can be used as a vehicle for strategic change. The findings of the study shed light on the on going changing orientations in the project business environment, increase understanding of the variety of ways in which customer references can be deployed as marketing assets, and provide a framework of the relevant tasks and activities related to building, managing and leveraging a firm's customer reference portfolio. The findings contribute to the industrial marketing research, to the literature on marketing assets and capabilities and to the literature on projects and solutions. The proposed functions and mechanisms of customer reference marketing bring a more thorough and structured understanding about the essence and characteristics of the phenomenon and give a wide ranging view of the role of customer references as marketing assets for B to B firms. The study suggests several managerial implications for industrial suppliers in order to systematise customer reference marketing efforts.

Pankin sisäisen siirtohinnoittelun merkitys ohjauksessa - tapaustutkimus Suomessa toimivasta pankista

Tutkimuksen tavoitteena oli tutkia, miten pankin käyttämä siirtohinnoittelumenetelmä toimii osana pankin ohjausjärjestelmää ja siten tukee organisaation kykyä ja motivaatioita toimia koko pankin kannalta kannattavasti. Ilmiötä tutkittiin tapaustutkimuksena Suomessa toimivassa pankissa. Tutkimuksessa kävi ilmi, että yrityksessä on meneillään siirtohinnoittelumallin muutosprojekti. Projektin tarkoituksena on parantaa kannattavuusseurantaa ja pitkällä tähtäimellä mallin on tarkoitus toimia strategian jalkauttamisen työvälineenä. Tutkimuksessa havaittiin, että siirtohinnoittelumallin keskeisin haaste on saada se sopeutumaan riittävän nopeasti markkinaolosuhteiden muutoksiin siten, että se tukee pankin strategisia tavoitteita. Konttoreiden tulosohjauksessa painotetaan tuloksen lisäksi erilaisia mittaristoja, jotka kuvaavat monipuolisemmin tulosyksikön suoriutumista. Tutkimuksen johtopäätöksenä havaittiin, että siirtohinnoittelumalli voi olla erinomainen johtamisen työkalu, jos se huomioi yrityskohtaiset, taloudelliseen toimintaympäristöön ja yrityksen strategiaan liittyvät erityisvaateet.

Concentrated Winding Multiphase Permanent Magnet Machine Design and Electromagnetic Properties – Case Axial Flux Machine

Concentrated winding permanent magnet machines and their electromagnetic properties are studied in this doctoral thesis. The thesis includes a number of main tasks related to the application of permanent magnets in concentrated winding open slot machines. Suitable analytical methods are required for the first design calculations of a new machine. Concentrated winding machines differ from conventional integral slot winding machines in such a way that adapted analytical calculation methods are needed. A simple analytical model for calculating the concentrated winding axial flux machines is provided. The next three main design tasks are discussed in more detail in the thesis. The magnetic length of the rotor surface magnet machines is studied, and it is shown that the traditional methods have to be modified also in this respect. An important topic in this study has been to evaluate and minimize the rotor permanent magnet Joule losses by using segmented magnets in the calculations and experiments. Determination of the magnetizing and leakage inductances for a concentrated winding machine and the torque production capability of concentrated winding machines with different pole pair numbers are studied, and the results are compared with the corresponding properties of integral slot winding machines. The thesis introduces a new practical permanent magnet motor type for industrial use. The special features of the machine are based on the option of using concentrated winding open slot constructions of permanent magnet synchronous machines in the normal speed ranges of industrial motors, for instance up to 3000 min-1, without excessive rotor losses. By applying the analytical equations and methods introduced in the thesis, a 37 kW 2400 min-1 12-slot 10-pole axial flux machine with rotor-surfacemounted magnets is designed. The performance of the designed motor is determined by experimental measurements and finite element calculations.

Surface Modification of Ceramics

Ceramics are widely used in industrial applications due to their advantageous thermal and mechanical stability. Corrosion of ceramics is a great problem resulting in significant costs. Coating is one method of reducing adversities of corrosion. There are several different thin film deposition processes available such as sol-gel, Physical and Chemical Vapour Deposition (PVD and CVD). One of the CVD processes, called Atomic Layer Deposition (ALD) stands out for its excellent controllability, accuracy and wide process capability. The most commonly mentioned disadvantage of this method is its slowness which is partly compensated by its capability of processing large areas at once. Several factors affect the ALD process. Such factors include temperature, the grade of precursors, pulse-purge times and flux of precursors as well as the substrate used. Wrongly chosen process factors may cause loss of self-limiting growth and thus, non-uniformities in the deposited film. Porous substrates require longer pulse times than flat surfaces. The goal of this thesis was to examine the effects of ALD films on surface properties of a porous ceramic material. The analyses applied were for permeability, bubble point pressure and isoelectric point. In addition, effects of the films on corrosion resistance of the substrate in aqueous environment were investigated. After being exposured to different corrosive media the ceramics and liquid samples collected were analysed both mechanically and chemically. Visual and contentual differences between the exposed and coated ceramics versus the untreated and uncoated ones were analysed by scanning electron microscope. Two ALD film materials, dialuminium trioxide and titanium dioxide were deposited on the ceramic substrate using different pulse times. The results of both film materials indicated that surface properties of the ceramic material can be modified to some extent by the ALD method. The effect of the titanium oxide film on the corrosion resistance of the ceramic samples was observed to be fairly small regardless of the pulse time.

Tulevaisuuden älykotiliiketoiminnan toimitusverkoston kartoitus

Tutkimus kartoitetaan tulevaisuuden älykotiliiketoiminnan palvelutuottaja-verkostoa. Lisäksi delphi-prosessia seuraten, pyritään kyselyn kautta vali-doimaan tulevaisuudesta tehty skenaario. Kysely tehtiin 42 yrityksen stra-tegiasta vastaavalle johtajalle. Selvitettäviä asioita olivat skenaarion liike-toiminnallinen kiinnostavuus, toteutumiskelpoisuus ja yrityksen siinä ha-luama rooli. Lisäksi selvitettiin mm. yritysten yhteistyökyvykkyyttä, innova-tiivisuutta, asiakassuuntautuneisuutta ja teknologinen valmiutta. Pääpaino oli selvittää verkoston muodostaja eli johtaja yritys. Kysely validoi kaikkien vastanneiden osalta tulevan skenaarion. Tulosten perusteella pystyttiin erottamaan 12 potentiaalista johtajaa. Nämä erottui-vat kyselyn kaikilla osa-alueilla parempina kuin muut yritykset. Potentiaali-set johtajat näkivät tulevaisuuden optimistisempana kuin muut ja lisäksi ne harjoittavat jo nyt liiketoimintaa, joka on lähellä kuvattua älykotipalveluver-kostoa. Tuloksia voidaan hyödyntää muodostettaessa palveluverkostoa uusille markkinoille. Kuvatun mallin toteutuminen vaatii kuitenkin julkisen sektorin palvelutoiminnan uudistusta, sillä se sisältää useita rinnakkaisia prosesseja julkisen terveydenhuollon kanssa.

A comparison of electricity spot prices simulation using ARMA-GARCH and mean-reverting models

The aim of this work is to compare two families of mathematical models for their respective capability to capture the statistical properties of real electricity spot market time series. The first model family is ARMA-GARCH models and the second model family is mean-reverting Ornstein-Uhlenbeck models. These two models have been applied to two price series of Nordic Nord Pool spot market for electricity namely to the System prices and to the DenmarkW prices. The parameters of both models were calibrated from the real time series. After carrying out simulation with optimal models from both families we conclude that neither ARMA-GARCH models, nor conventional mean-reverting Ornstein-Uhlenbeck models, even when calibrated optimally with real electricity spot market price or return series, capture the statistical characteristics of the real series. But in the case of less spiky behavior (System prices), the mean-reverting Ornstein-Uhlenbeck model could be seen to partially succeeded in this task.

Organisaatiorakenteiden vaikutuksia yritysten innovatiivisuuteen

Tämän työn tavoitteena oli selvittää, miten erilaiset organisaatiorakenteet vaikuttavat yritysten innovatiivisuuteen. Siinä käsitellään organisaatioiden rakenteiden jaottelua ja ominaisuuksia, ja käydään läpi innovatiivisuuteen tarvittavia resursseja ja siihen vaikuttavia ympäristön ominaisuuksia. Työn lopuksi tarkastellaan eri rakennemallien innovatiivisuutta edistäviä ja estäviä tekijöitä, ja tehdään yhteenveto innovatiivisuuden kannalta hyvistä ja huonoista rakenteista. Organisaatiorakenteet jaotellaan kuuteen malliin, mutta käytännössä niistä voidaan luoda yhdistelmiä kunkin organisaation tarpeen mukaan. Rakenteilla huomattiin olevan vaikutusta innovatiivisuuteen. Voidaan sanoa, että innovaatioiden kannalta parhaita ovat rakenteeltaan joustavat organisaatiot, joissa on matala hierarkiataso ja runsaasti kommunikaatiota. Esimerkkinä sellaisesta toimii erityisesti matriisirakenne. Huonosti innovaatiotoimintaa tukevia ovat toiminto- ja divisioonarakenteet, lähinnä joko reagoinnin hitauden tai asiantuntijuuden pinnallisuuden takia. Yrityksen tulee löytää tasapaino joustavuuden ja byrokratian välillä saavuttaakseen omalla toimialallaan tarpeellisen innovatiivisuuden. Sen tulee myös perehtyä tarpeisiinsa ja arvioida millaisia päämääriä todellisuudessa halutaan saavuttaa. Innovaatiotoiminnan kehittämisessä yrityksen johdon tulee ottaa huomioon nämä päämäärät ja kyseisen organisaation rakenne.

Uudistumiskyvyn ja innovatiivisuuden kehittäminen muutoshaasteena

Tämän Pro Gradun tavoitteena oli selvittää organisaation uudistumiskyvyn ja innovatiivisuuden kehittämisprosessiin liittyviä kriittisiä menestystekijöitä konsultin näkökulmasta. Työn toisena tavoitteena oli tuottaa karkea malli konsultointimetodista, jota erityisesti uudistumiskyvyn ja innovatiivisuuden kehittämisen parissa työskentelevät voisivat hyödyntää. Aluksi työssä tarkastellaan, mitä konsultointiprojektin menestyksen kannalta kriittisiä tekijöitä aiemmissa tutkimuksissa on havaittu. Tutkimuksen empiirisessä osassa kerättiin konsulttien näkemyksiä kriittisistä tekijöistä sekä siitä, kuinka uudistumiskyvyn ja innovatiivisuuden kehittämisen konsultointi poikkeaa muusta konsultoinnista. Tämän tutkimuksen tärkein tulos oli havainto, että selkeä ja toimijoiden kesken yhtenevä näkemys haasteista sekä kohdeorganisaation jäsenten laaja osallistaminen diagnoosi-, suunnittelu- ja toimeenpanovaiheen kaikissa toimissa edesauttavat hyvää ja kestävää lopputulosta. Konsultin keskeisin tehtävä on toimia jäsentelijänä, sparraajana, valmentajana sekä toteutuksen tukijana ja varmistajana.

Evolution of Bioaffinity Reagents by Phage Display

Antibodies are natural binding proteins produced in vertebrates as a response to invading pathogens and foreign substances. Because of their capability for tight and specific binding, antibodies have found use as binding reagents in research and diagnostics. Properties of cloned recombinant antibodies can be further improved by means of in vitro evolution, combining mutagenesis with subsequent phage display selection. It is also possible to isolate entirely new antibodies from vast naïve or synthetic antibody libraries by phage display. In this study, library techniques and phage display selection were applied in order to optimise binding scaffolds and antigen recognition of antibodies, and to evolve new and improved bioaffinity reagents. Antibody libraries were generated by random and targeted mutagenesis. Expression and stability were mainly optimised by the random methods whereas targeted randomisation of the binding site residues was used for optimising the binding properties. Trinucleotide mutagenesis allowed design of defined randomisation patterns for a synthetic antibody library. Improved clones were selected by phage display. Capture by a specific anti- DHPS antibody was exploited in the selection of improved phage display of DHPS. Efficient selection for stability was established by combining phage display selection with denaturation under reducing conditions. Broad-specific binding of a generic anti-sulfonamide antibody was improved by selection with one of the weakest binding sulfonamides. In addition, p9 based phage display was studied in affinity selection from the synthetic library. A TIM barrel protein DHPS was engineered for efficient phage display by combining cysteinereplacement with random mutagenesis. The resulting clone allows use of phage display in further engineering of DHPS and possibly use as an alternative-binding scaffold. An anti-TSH scFv fragment, cloned from a monoclonal antibody, was engineered for improved stability to better suite an immunoassay. The improved scFv tolerates 8 – 9 °C higher temperature than the parental scFv and should have sufficient stability to be used in an immunoanalyser with incubation at 36 °C. The anti-TSH scFv fragment was compared with the corresponding Fab fragment and the parental monoclonal antibody as a capturing reagent in a rapid 5-min immunoassay for TSH. The scFv fragment provided some benefits over the conventionally used Mab in anayte-binding capacity and assay kinetics. However, the recombinant Fab fragment, which had similar kinetics to the scFv, provided a more sensitive and reliable assay than the scFv. Another cloned scFv fragment was engineered in order to improve broad-specific recognition of sulfonamides. The improved antibody detects different sulfonamides at concentrations below the maximum residue limit (100 μg/kg in EU and USA) and allows simultaneous screening of different sulfonamide drug residues. Finally, a synthetic antibody library was constructed and new antibodies were generated and affinity matured entirely in vitro. These results illuminate the possibilities of phage display and antibody engineering for generation and optimisation of binding reagents in vitro and indicate the potential of recombinant antibodies as affinity reagents in immunoassays.

The Role of Integrins in Enterovirus Infections and in Metastasis of Cancer

Integrins are a family of transmembrane glycoproteins, composed of two different subunits (alpha and beta). Altered expression of integrins in tumor cells contributes to metastasis tendency by influencing on the cells‟ attachment to adjacent cells and their migration. Viral pathogens, including certain enteroviruses, use integrins as receptors. Enteroviruses have also been suggested to be involved in the etiopathogenesis of type 1 diabetes. The study focuses on the role of integrins in the pathogenesis of metastasis to cortical bone and on type 1 diabetes (T1D) and echovirus 1 infection. In the first part of the thesis, the role of different integrins in the initial attachment of MDA-MD-231 breast cancer cells to bovine cortical bone disks was studied. A close correlation between alpha2beta1 and alpha3beta1 integrin receptor expression and the capability of the tumor to attach to bone were observed. In the second part, a possible correlation between susceptibility to enterovirus infections in diabetic children and differences in enterovirus receptor genes, including certain integrins, was investigated. In parallel, virus-specific neutralizing antibodies and diabetic risk alleles were studied. In the diabetic group, an amino acid change was detected in the polio virus receptor and the neutralizing antibody titers against echovirus 30 were lower. However, to obtain statistically sustainable results, a larger number of individuals should be analyzed. Echovirus 1 (EV1) enters cells by attaching to the alpha2I domain of the alpha2beta1 integrin. In the third part EV1 was shown to attach to a chimeric receptor construct of the transferrin receptor and the alpha2I domain and to enter cells through clathrin-mediated endocytosis that is normally not used by the virus. The chimeric receptor was recycled to the plasma membrane, whereas the virus remained in intracellular vesicles. The virus replication cycle was initiated in these cells, suggesting that evolution pressure could possibly cause the virus to evolve to use a different entry mechanism. Moreover, a cDNA microarray analysis of host gene expression during EV1 replication showed that 0.53% of the total genes, including several immediate early genes, were differently expressed.

Electric propulsion system in a modern sports car

In this thesis an electric propulsion system is designed on a device level using Cadence ORCAD. The vehicle belongs to the Helsinki Metropolia University of Applied Sci-ences and it is to compete in the Automotive X-Prize competition held in the USA. In this thesis the electric propulsion system and related electric safety measures are designed. Also electro-magnetic compatibility and interferences present in the system are examined by examining the birth mechanisms and transmission paths of interference. Per device effects of interference and solutions to minimize them were examined and proposed. Suitability of permanent magnet synchronous machines for passenger vehicle use was examined by examining the torque production capability of the motor and the torque requirements of the vehicle. Also a short overview of history of electric vehicles is given.

Lappeenranta-malli alueellisen julkisen verkon toteutustapana

Työssä perehdytään tapoihin, joilla alueellinen julkinen verkko voidaan toteuttaa. Työn lähtökohtana on näkemys, että tietoyhteiskunnassa pääsy verkkoon on perusedellytys. Tällöin lähes kaikissa kodeissa tulisi olla mahdollisuus kytkeytyä ja olla jatkuvasti kytkeytyneenä tietoverkkoon. Lappeenranta-malli määrittelee tavan toteuttaa alueellisen julkisen verkon peruspalvelut. Mallin erityispiirteenä on mahdollisuus ilmoitusten esittämiseen verkon käyttäjille. Työssä arvioidaan Lappeenranta-mallin sopivuutta alueellisen julkisen verkon toteutustavaksi ja mitataan mallin suorituskykyä. Työn osana toteutetaan Lappeenranta-malliin kuuluva yhdysliikennepiste Lappeenrannan teknillisen yliopiston käyttöön.

The relationship between first-order capabilities and online innovations. A comparative case study on the publishing sector.

The objective of this thesis was to study the relationship between firstorder capabilities and online innovations. First-order capabilities can be divided into market and technology capabilities, and they play an important role in the production of innovations. The study was carried out in publishing industry, where many changes have taken place in the online environment during the last few years. In the empirical research, four companies were studied, two magazine publishers and two newspaper publishers. The analysis was done in two phases; first every case was analyzed alone and then the cases were compared in cross-case analysis. The most important finding was the positive impact of market capability to the production of online innovations. The study also increased understanding about the relationship between market and technology capabilities and online innovations in general.

Cost evaluation process for competitors' products

A company’s capability to map out its cost position compared to other market players is important for competitive decision making. One aspect of cost position is direct product cost that illustrates the cost efficiency of a company’s product designs. If a company can evaluate and compare its own and other market players’ direct product costs, it can implement better decisions in product development and management, manufacturing, sourcing, etc. The main objective of this thesis was to develop a cost evaluation process for competitors’ products. This objective includes a process description and an analysis tool for cost evaluations. Additionally, process implementation is discussed as well. The main result of this thesis was a process description consisting of a sixteen steps process and an Excel based analysis tool. Since literature was quite limited in this field, the solution proposal was combined from many different theoretical concepts. It includes influences from reverse engineering, product cost assessment, benchmarking and cost based decision making. This solution proposal will lead to more systematic and standardized cost position analyses and result in better cost transparency in decision making.