Local Embeddedness and Knowledge Acquisition and How They Affect Finnish Business Operations in Russia

This pilot project aims examine the factors of the Finnish subsidiaries local embeddedness, their knowledge creation capabilities and the transfer mechanisms of new practices in the context of the Russian market. The research is designed as a multiple case study conducted with a qualitative approach. The empirical data consists of the interviews of the four Finnish case companies operating in the Kaluga region and three local partner companies. The deductive and inductive approaches were employed to conduct the analysis of the data. The propositions for the future study were developed in the conclusive chapters of the research, where we propose that the factor of the economy growth and industrialization matters in terms of subsidiaries’ role dedication, their knowledge creation capabilities, and direction of the knowledge flow within the local environment.

Emotional intelligence and multicultural project leadership in Finnish-Chinese MNC context

The main goal of this thesis was to examine how the emotional intelligence skills and multicultural project leadership style of a project manager interrelate and affect the success of a project. The research methods used are literature review in theoretical part of the thesis and semi-structured interviews in empirical part of the thesis. This study is a single case study i.e. one case company was selected to be the secondary level of analysis. Within the case company, four project managers were selected as research units to form the primary level of analysis. Literature review formed the basis for the empirical research and the interview questions were derived from the literature. Findings from the interviews were mirrored against the literature review findings, based on which both conclusions and generalisations could be made. Thus, both deductive and inductive methods were utilised to get more complete picture about the research topic. In the first part of the literature review the general leadership theories and the project leadership terminology are introduced as a background for the concept of emotional intelligence and the integrated leadership model. Emotional intelligence and its interrelation to different leadership concepts are discussed during the literature review. Chinese cultural aspects affecting the way of making business, and the multicultural leadership styles of the Finnish project managers are introduced in the following part of the literature review. It was found that the most successfully used multicultural leadership styles in Finnish-Chinese context are synergistic and polycentric, and these require emotional intelligence skills. In the empirical part on this thesis the findings from the semi-structured interviews are introduced, discussed and analysed. Interviews were done in private meeting rooms, and they were recorded and transcripted to add reliability and validity. Although the sample was only four project managers, the results show that the sample is quite saturated as the responses to several questions followed the same pattern. It was found that Finnish project managers in the case company are democratic and take cultural differences into account in their project leadership. Both synergistic and polycentric leadership styles are used with Chinese team members. Emotional intelligence capabilities and the emphasis of those differ a bit depending on the interviewee. Though, the results show that EI skills and the multicultural project leadership style used in Chinese context are interrelated. The findings from the literature review and the empirical research in this thesis are similar. Though, there is need for further research as the sample was small, and this thesis is a single case study. It is recommendable to make a multi-company study with larger sample of project managers. Also multi-industry perspective is recommendable for further research.

Den Äldsta – livet är ett tillägnande : en vårdvetenskaplig explorativ studie av ett meningsbärande budskap och en innerlig visdom

In the background of the thematic The Eldest – life is acquiring one finds both previews and myths. Wisdom belongs to these myths. The hermeneutical philosophy refers to thinking as o movement from myth to logos in a dialogical oneness. The research uncovers dimensions in the element wisdom as empowered. The experiences of older are saved for further learning and transformation to younger with reference to vulnerable situations where common regulations are no more usefull. The interest goes to an Eldest. The Eldest in the study is pictorial in accordance to the main literature in the study.The Eldest is etymological, fictive and symbolic: – a man who understands higher matters of life, even Gods holy matters. She will set the fulfillment of others as the highest endowment out of an innermost ethos and an innermost wisdom. The innermost is wisdom. The aim is to discover a meaningful message in life is acquiring. In order to see and to learn from the experiences the study aim to uncover the innermost, an innermost wisdom out of a caritative approach. This innermost is anticipated as a longing for unity and health in dayly matters and in a caring ability for the other. The main overstatement is: What will this most meaningfull and innermost by the Eldest out of a living in factual life mirrored in a caring perspective be? Two questions expired; what will the meaningful message in the acquiring be? What will the innermost wisdom in serving the good be? This message and its innermost wisdom will get an expanded meaning out of a caring sentence: Man who dare – seeing back with gratitude, seeing forward in confidence, seeing aside with love and upward in fate wear that dignity, that holiness and that mercy and empathy which belong to life in its basics. The persons attending the research are situated in two contexts. One group has roots in the Lutheran church and the other in a caring profession. The datamaterial is formed out of the usages from these persons, from the spoken (conversation) and the written word (a guestbook). The usages as particular and common are continually integrated in the leading caring sentence from the beginning of the study to the end. The usages stand by the methodological for the final message and wisdom and at the same they form the operative dimension in the study, the evident and the validity. The overarching methodological approach is in the hermeneutic philosophy in accordance with the abductive logic. The usages out of two research groups are most significant in this deductive, inductive and abductive strategy. The usages from the research groups are confronted with the caring sentence in dialogical spaces, halts. The meaning and the innermost searched for will be pictured through the abductive and hermeneutic interpretation and will stand for an articulation of and a successively expansion of meaning. A twine of horizons out of the entire dissemination, the deductive and the inductive, creates the result, as the final message as the ground for an understanding of an even more embracing meaning in an innermost wisdom. The identified bearing movement in the groups in accordance with the caring sentence goes for something higher, something higher than me, to the wellbeing of the other. A conclusion is made and a thesis is identified. This thesis is out from the usages: What can I do in a creating of this caritative? An antithesis is also identified, is a man able to look outside one own and go to something higher, something greater? The synthesis is articulated as a dialogical movement from something … to something higher. The bridge could be maturation, transcendence, the divine or wisdom. The statement finds its root in the attending groups but a difference is also identified. This higher matter is different. The contexts and their meaningfulness decide. A final statement is: learn to see man and her matters hold in life.

BALANSED SCORECARDIN IMPLEMENTOINTI JA HYÖDYNTÄMINEN CASE: PROAGRIA ETELÄ-KARJALAN MAASEUTUKESKUS

Tutkimuksen tavoitteena oli tutkia ProAgria Etelä-Karjalan Maaseutukeskuksen balanced scorecard -mittaristoa. Tutkimuksessa selvitettiin mittariston käyttöönottoprosessia muodostamispäätöksestä hyödyntämiseen. Tutkimusmetodologiaksi on valittu case-tutkimus. Teoriaosassa käsitellään strategista johtamista yleisesti ja asiantuntija- ja voittoa tavoittelemattomien organisaatioiden osalta sekä balanced scorecardin muodostumista, suorituskyvyn mittaamista ja mittariston käyttömahdollisuuksia. Tutkimuksen empiirisessä osassa analysoidaan Maaseutukeskuksen mittariston käyttöönottoprosessin nykytilaa ja esitetään tulosten perusteella muodostetut kehitysehdotukset. Tutkimuksen perusteella voidaan todeta, että Maaseutukeskuksen käyttöönottoprosessi ei ole sujunut odotusten mukaisesti, mutta strategian ja mittariston yhteyden selvittämisen jälkeen voi sisäistämisprosessi alkaa koko organisaation laajuudessa. Mittariston tavoitteiden mukainen hyödyntäminen vaatii koko henkilöstön sitoutumista strategiaan ja seuraamista henkilökohtaisten ja koko organisaation tavoitteiden toteutumista mittariston avulla.

Marketers’ perception of the implementation of social media marketing: Evidence from large Finnish companies’ marketing campaigns

Social media is a multidimensional marketing and communications channel which can support and enhance a business’ reputation, sales and even longevity. Social media as a business tool encourages an interaction between customers and companies which gives opportunities for a company to better understand their customers, to target them more effectively and to collaborate and create dialogues with them which is not possible through traditional media channels. The aim of a social media strategy is to increase brand awareness, image, loyalty and recognition. The peer networks that social media creates allows a company to disseminate information through loyal customers to new and prospective customers to ultimately increase reach. The purpose of the study is to understand the marketer’s perspective of social media marketing use and how it is currently utilized in marketing and communications activities in Finland. Three companies were interviewed covering fourteen different implementations of social media marketing campaigns. These were then analysed to ascertain the utilization methods and experience gained on recent campaigns in the Finnish market The utilization of social media marketing was analysed using the methods of thematic analysis and inductive and abductive reasoning. Elements and themes were drawn out of the separate interviews to create a framework with which to explore, evaluate and match theories that define social media usage by companies. It became clear from all of the interviews that social media as a tool is most effective when it captures the viewer’s interest through rich and entertaining content. This directed the theoretical research towards Engagement Theory and Content Marketing which look to emphasize the importance of communities, collaboration, interaction, and peer-sharing as the key drivers of a social media marketing campaign.

Vahinkoeläinsodasta psykologiseen omistajuuteen. Petokonfliktien historiallinen tausta ja nykypäivän hallinta

Suurpetojen kannanhoitoon, ja etenkin suden kannanhoitoon liittyvä monitahoinen konfl ikti esiintyy jännitteinä paikallisyhteisöjen ja keskushallinnon, maaseudun ja kaupunkien sekä maallikoiden ja tutkijoiden välillä. Suurpetopolitiikan legitimiteettikriisi näkyy kansallisen kannanhoidon tavoitteiden ja toimenpiteiden kiistämisenä passiivisin ja aktiivisin toimin. Tällä ajankohtaisella ongelmalla on mittavat historialliset juuret. Luonnon ja ihmisen välinen suhde on ollut jatkuvaa tasapainottelua konfl iktien ja niiden hallinnan kanssa, ja suurpedot ovat väistämättä olleet konfl iktin keskiössä lajityypillisten piirteidensä vuoksi. Tämän tutkimuksen tavoitteena on osoittaa ympäristöhistoriallisen tutkimusotteen kautta suomalaisen vahinkoeläinhistorian keskeiset toimet ja toimijat, sekä ymmärtää vahinkoeläinten kannanhoidon tavoite- ja toimenpideasettelun vaikutukset eläinpopulaatioihin historiallisessa ja ekologisessa kontekstissa. Tutkimuksen toinen tavoite on tuottaa synteesi nykypäivän suurpetojen kannanhoidon tavoite- ja toimenpiteiden tarkoituksenmukaisuudesta ja vaikuttavuudesta historiallisessa kontekstissa ja esittää uudenlainen lähestymismalli sosiaalisesti kestävämmälle suurpetopolitiikalle. Vahinkoeläinhistoriaa käsitellään deduktiivisella ja rekonstruktiivisella tutkimusotteella käyttäen aineistona lakitekstejä, maksettuja tapporahoja, sanomalehtikirjoituksia, sidosryhmien kirjoituksia sekä eläintieteellisiä julkaisuja. Etenkin laeissa ja asetuksissa eri eläimistä asetetut tapporahat ja toisaalta saalistilastojen perusteella maksetut palkkiot on nostettu tässä tutkimuksessa merkittävään rooliin asenteiden tulkinnan välineenä. Tarkastelu ulotetaan nisäkkäiden lisäksi myös lintuihin, jotka ovat edellä mainitun aineiston valossa olleet merkittävä vainottu eläinryhmä. Nykypäivän petokonfl iktin tarkastelussa keskiöön nostetaan suurpetoasenteet, niiden muodostuminen ja vaikutus suurpetopolitiikan tavoitteiden ja toimenpiteiden kiistämisessä. Suurpetopolitiikan legitimiteettikriisiä tarkastellaan paikallisten uhmakkuutena hallintoa kohtaan ja tulkinta keinoista puuttua sosiopoliittiseen rikokseen rakennetaan tätä ajatusta vasten. Suurpetojen salakaatajat toimivat yhteisönsä puolesta ja saavat tukensa toimilleen yhteisöltään. Sosiopoliittinen rikos ei siten ole ainoastaan salakaatajien vaan sen sijaan yhteisön yhteinen. Salakaatajat ja paikallisyhteisö pyrkivät häivyttämään yhteiskunnassa viranomaisten ja sidosryhmien taholta toimintaan liittämää stigmaa ja siten oikeuttamaan tekonsa vallitsevissa olosuhteissa. Arvoristiriitoihin perustuvat konfl iktit ovat haasteellisia hallita ja lähtökohtana on oltava ymmärrys siitä, että etenkin suteen liittyvät jännitteet ja ristiriidat ihmisten välisissä suhteissa ovat väistämättömiä. Tunnistamalla historiallisen aineiston merkittävyys nykypäivän ongelmakeskeisen kannanhoidon ratkaisun tietopohjana on mahdollista rakentaa sosiaalisesti kestävämpää suurpetojen kannanhoitoa. Tässä väitöskirjatyössä painotetaan suurpetoihin liittyen ajatusta, jonka mukaan paikallisilta suurpetoalueilla eläviltä ihmisiltä tai sidosryhmien edustajilta ei edellytetä arvomaailman muuttumista, vaan hyväksytään heidän käsityksensä suurpetojen roolista vahingontekijöinä. Sen sijaan vahvistetaan suurpetojen välineellistä roolia paikallisyhteisöjen resurssina ja oleellisten sidosryhmien roolia yhteisön toimijoina psykologisen omistajuuden rakentamisen kautta. Suurpetojen kestävä kannanhoito vaatii siten riistahallinnon toimintakulttuurin muutosta ja uudenlaista suhdetta yhteiskunnan eri toimijoihin.

Patient-perceived health-related quality of life during recovery after total hip arthroplasty – a 6-month follow-up study

Potilaiden käsitys terveyteen liittyvästä elämänlaadusta lonkan tekonivelleikkauksen jälkeisenä toipumisaikana – kuuden kuukauden seurantatutkimus Tässä kaksivaiheisessa seurantatutkimuksessa tarkasteltiin potilaiden käsitystä terveyteen liittyvästä elämänlaadusta lonkan tekonivelleikkauksen jälkeisenä toipumisaikana. Tutkimuksen ensimmäisessä vaiheessa tarkoituksena oli sekä kuvailla potilaiden kokemuksia potilaana olosta, saamastaan hoidosta ja terveyspalveluorganisaatiosta että analysoida aikaisempien tutkimusten perusteella leikkauksen tuloksia potilaan kannalta. Toisessa vaiheessa tarkoituksena oli arvioida potilaiden kokemaa elämänlaatua leikkauksen jälkeen, ja sitä vaikuttivatko primaaritulokset (fyysinen toimintakyky, kipu, ahdistus) tai taloudelliset seuraukset (potilaiden itsensämaksamat kustannukset, palvelujen käyttö) terveyteen liittyvään elämänlaatuun. Tutkimuksen tavoitteena oli löytää mahdolliset kriittiset ajankohdat tai tekijät, jotka saattavat hidastaa toipumista ja siten huonontaa potilaiden elämänlaatua. Tätä tietoa voidaan käyttää hoitotyössä kun suunnitellaan sopivaa hoitoa ja tukea toipumisajalle. Tutkimuksen ensimmäisessä vaiheessa primaarileikkaukseen tulevat potilaat (n = 17) kuvailivat teemahaastatteluissa kokemuksiaan kahdesti leikkauksen jälkeen. Haastatteluaineisto analysoitiin induktiivisella sisällönanalyysilla. Lisäksi 17 tutkimusartikkelista analysoitiin deduktiivisella sisällönanalyysilla leikkauksen tuloksia potilaalle, tuloksiin vaikuttavia tekijöitä ja käytetyt tutkimusmetodit. Toisessa vaiheessa primaari- tai revisioleikkaukseen tulevat potilaat (n = 100) arvioivat leikkauksen tuloksia kuuden kuukauden ajan leikkauksen jälkeen: terveyteen liittyvää elämänlaatua, primaarituloksia ja taloudellisia seurauksia. Aineisto kerättiin erilaisilla mittareilla: Sickness Impact Profile, Finnish Version, Stait-Trait Anxiety Inventory, ja Numeric Rating Scale. Lisäksi käytettiin tätä tutkimusta varten tehtyjä kyselylomakkeita: Fyysinen toimintakyky-mittari, Palvelujen käyttö-mittari ja Kustannusmittari. Tutkimuksen toiseen vaiheen tulokset analysoitiin tilastollisilla menetelmillä. Potilaiden terveyteen liittyvä elämänlaatu parani ja kipu lievittyi leikkauksen jälkeen ja fyysinen toimintakyky lisääntyi toipumisaikana. Positiivisista muutoksista huolimatta potilaat kokivat ahdistusta samassa määrin kuin ennen leikkaustakin. Palvelujen käyttö vaihteli toipumisajan kuluessa ja potilaiden maksamissa kustannuksissa oli suuria vaihteluita. Fyysisen toimintakyvyn lisääntyminen ja kivun lieveneminen paransivat terveyteen liittyvää elämänlaatua. Sen sijaan huonompi elämänlaatu toipumisaikana oli yhteydessä suurempaan palvelujen käyttöön, kun taas kustannuksilla ei ollut yhteyttä elämänlaatuun. Potilaiden ominaispiirteet tulisi ottaa enemmän huomioon suunniteltaessa sopivaa leikkauksenjälkeistä hoitoa ja tukea. Potilaat tarvitsevat yksilöllisiä ohjeita, sillä monet taustatekijät (esim. ikä, sukupuoli, preoperatiivinen kipu, siviilisääty, ja leikkaustyyppi) vaikuttavat toipumiseen.

Oops! Another medication error : a literature review of contributing factors and methods to prevent medication errors

The purpose of this bachelor's thesis was to chart scientific research articles to present contributing factors to medication errors done by nurses in a hospital setting, and introduce methods to prevent medication errors. Additionally, international and Finnish research was combined and findings were reflected in relation to the Finnish health care system. Literature review was conducted out of 23 scientific articles. Data was searched systematically from CINAHL, MEDIC and MEDLINE databases, and also manually. Literature was analysed and the findings combined using inductive content analysis. Findings revealed that both organisational and individual factors contributed to medication errors. High workload, communication breakdowns, unsuitable working environment, distractions and interruptions, and similar medication products were identified as organisational factors. Individual factors included nurses' inability to follow protocol, inadequate knowledge of medications and personal qualities of the nurse. Developing and improving the physical environment, error reporting, and medication management protocols were emphasised as methods to prevent medication errors. Investing to the staff's competence and well-being was also identified as a prevention method. The number of Finnish articles was small, and therefore the applicability of the findings to Finland is difficult to assess. However, the findings seem to fit to the Finnish health care system relatively well. Further research is needed to identify those factors that contribute to medication errors in Finland. This is a necessity for the development of methods to prevent medication errors that fit in to the Finnish health care system.

Creating and Internalizing Corporate Brand Identity, Case Wärtsilä

Tämän tutkimuksen tavoitteena oli paremmin ymmärtää yritysbrandin identiteetin käsitettä sekä tutkia, miten brandi-identiteetti voidaan luoda ja sisäistää globaalissa konsernissa. Tutkimuksen tarkoituksena oli myös selvittää mahdollisia eroavuuksia case-yritys Wärtsilän todellisen ja toivotun brandi-identiteetin välillä. Kattavan kirjallisuuskatsauksen avulla tarkasteltiin yritysbrandin käsitettä ja sen merkitystä liiketoiminnassa sekä sitä, minkälaisen prosessin avulla yritysbrandi voidaan rakentaa. Myös brandi-identiteetin sisäistämiskeinoja pyrittiin löytämään kirjallisuuskatsauksen avulla. Wärtsilän toivottua brandi-identiteettiä tutkittiin teemahaastattelujen avulla. Henkilöstön mielikuvia eli todellista sisäistä brandi-identiteettiä selvitettiin kvantitatiivisella kyselytutkimuksella. Tutkimus osoitti, että yritysbrandin identiteetti on käsitteenä monitahoinen ja että sillä on yhtymäkohtia useisiin rinnakkaisiin käsitteisiin, kuten yrityksen identiteettiin, uskottavuuteen, maineeseen, liiketoimintastrategiaan, visioon ja missioon. Tämä tutkimus esittääkin, että yritysbrandin identiteetin käsittelyn tulisi aina olla kokonaisvaltaista, jotta saavutettaisiin jotakin rakentavaa ja arvokasta. Tutkimuksessa todetaan myös, että yritysbrandin rooli tulee tulevaisuudessa kasvamaan, koska kestävän kilpailuedun saavuttaminen tulee entistä vaikeammaksi. Tutkimus tähdentää myös henkilöstön roolin merkitystä yritysbrandin kehittämisessä. Tämän tutkimuksen mukaan yritysbrandin identiteetti voidaan luoda portaittaisen mallin avulla: Ensin tehdään strategiset brandianalyysit, määritellään toivotut mielikuvat ja positiointi, toisin sanoen brandin olemus, ja lopuksi nämä kaikki yhdistetään brandilupaukseksi. Yrityksen henkilöstön tulee sisäistää brandilupaus, jotta sen viestiminen ulospäin olisi mahdollisimman yhdenmukaista. Sisäistämistä voidaan edesauttaa mm. luomalla brandikirja, video, yritystarina, roolimalleja, käyttämällä yrityksen Intranettiä sekä pitämällä seminaareja ja ”workshopeja”. Tutkimuksessa havaittiin, että luomisprosessiin vaikuttavat monenlaiset tekijät, kuten muuttuva globaali liiketoimintaympäristö, organisatoriset asiat sekä moninaiset sidosryhmät.

Engendering Group Support Based Foresight for Capital Intensive Manufacturing Industries - Case Paper and Steel Industry Scenarios by 2018

In recent times of global turmoil, the need for uncertainty management has become ever momentous. The need for enhanced foresight especially concerns capital-intensive industries, which need to commit their resources and assets with long-term planning horizons. Scenario planning has been acknowledged to have many virtues - and limitations - concerning the mapping of the future and illustrating the alternative development paths. The present study has been initiated to address both the need of improved foresight in two capital-intensive industries, i.e. the paper and steel industries and the imperfections in the current scenario practice. The research problem has been approached by engendering a problem-solving vehicle, which combines, e.g. elements of generic scenario process, face-to-face group support methods, deductive scenario reasoning and causal mapping into a fully integrated scenario process. The process, called the SAGES scenario framework, has been empirically tested by creating alternative futures for two capital-intensive industries, i.e. the paper and steel industries. Three scenarios for each industry have been engendered together with the identification of the key megatrends, the most important foreign investment determinants, key future drivers and leading indicators for the materialisation of the scenarios. The empirical results revealed a two-fold outlook for the paper industry, while the steel industry future was seen as much more positive. The research found support for utilising group support systems in scenario and strategic planning context with some limitations. Key perceived benefits include high time-efficiency, productivity and lower resource-intensiveness. Group support also seems to enhance participant satisfaction, encourage innovative thinking and provide the users with personalised qualitative scenarios.

An Infant with Food Allergy and Eczema in the Family – The Mental and Economic Burden of Caring

Allergic diseases including food allergy and eczema in an infant in combination with the everyday activities of caring for a family will pose challenges to parents. Only fragments of these challenges are revealed to health care professionals. Families have varying mental, social and economic resources to help them care for an allergic infant, and all such resources are important in determining how families succeed in meeting these challenges and the quality of the infant’s care. This study evaluated the whole burden to the family caused by an infant's allergic disease during the first 24 months of life. As the primary caregiver during this period is usually the mother, her perspective was considered important. Ecocultural theory, which considers families as capable of modifying the positive and negative forces facing them, was taken as the frame of reference. Data were collected as part of an ongoing prospective mother-infant study, and the methods included severity scoring of atopic dermatitis, dietary records, health-related quality of life measurements and assessments of the use of health care services and medications for treating the infant’s eczema, food allergy and asthma. Interviews with mothers were analysed by deductive content analysis on the basis of ecocultural theory and the family empowerment model. The theme “Living an ordinary family life” guided the organization of family activities essential for treating the infant's food allergy and eczema. These activities were sources of both strain and support for the mothers, the allergy-related supporting factors being the mother’s own knowledge of the allergy, hopes for an improvement in the infant’s condition, social support and work. An infant’s food allergy at the age of one year caused considerable strain for the mother in cases where the introduction of new foods into the child’s diet was delayed. This delay was still causing the mother additional strain when the child was 24 months of age. The infants waking at night at the ages of 12 and 24 months because of itching related to eczema caused strain for the mothers. The infants’ health-related quality of life was impaired at ages of 6 and 12 months compared with healthy infants. The principal reasons for impairments were itching, scratching and sleep disturbances at 6 and 12 months and treatment difficulties at 6 months. Problems with getting to sleep were reported at all stages irrespective of eczema and were also present in healthy infants. The economic impact of the treatment of allergic diseases on families during the first 24 months was 131 EUR (2006 value) in cases of eczema and 525 EUR in cases of food allergy. From the societal perspective, the costs of food allergy were a median of 3183 EUR (range 628–11 560 EUR) and of eczema a median of 275 EUR (range 94–1306 EUR). These large variations in costs in food allergy and eczema indicate that disease varies greatly . In conclusion, food allergy and eczema cause extra activities and costs to families which arrange these disease-related activities in such a way that they support the leading family theme “Living an ordinary family life”. Health care professionals should consider this thematic character of family life and disease-related activities in order to ensure that new treatments are sustainable, meaningful and tailored to daily activities. In addition, those mothers who are experiencing difficulties with food allergic infants or infants with eczema should be recognized early and provided with individual encouragement and support from health clinics. In the light of the present results, early detection of symptoms and effective parental guidance can contribute to the well-being and health-related quality of life of the child and family.

Integration in project business : mechanisms for integrating customers and the project network during the life-cycle of industrial projects

This thesis focuses on integration in project business, i.e. how projectbased companies organize their product and process structures when they deliver industrial solutions to their customers. The customers that invest in these solutions run their businesses in different geographical, political and economical environments, which should be acknowledged by the supplier when providing solutions comprising of larger and more complex scopes than previously supplied to these customers. This means that the suppliers are increasing their supply range by taking over some of the activities in the value chain that have traditionally been handled by the customer. In order to be able to provide the functioning solutions, including more engineering hours, technical equipment and a wider project network, a change is needed in the mindset in order to be able to carry out and take the required responsibility that these new approaches bring. For the supplier it is important to be able to integrate technical products, systems and services, but the supplier also needs to have the capabilities to integrate the cross-functional organizations and departments in the project network, the knowledge and information between and within these organizations and departments, along with inputs from the customer into the product and process structures during the lifecycle of the project under development. Hence, the main objective of this thesis is to explore the challenges of integration that industrial projects meet, and based on that, to suggest a concept of how to manage integration in project business by making use of integration mechanisms. Integration is considered the essential process for accomplishing an industrial project, whereas the accomplishment of the industrial project is considered to be the result of the integration. The thesis consists of an extended summary and four papers, that are based on three studies in which integration mechanisms for value creation in industrial project networks and the management of integration in project business have been explored. The research is based on an inductive approach where in particular the design, commissioning and operations functions of industrial projects have been studied, addressing entire project life-cycles. The studies have been conducted in the shipbuilding and power generation industries where the scopes of supply consist of stand-alone equipment, equipment and engineering, and turnkey solutions. These industrial solutions include demanding efforts in engineering and organization. Addressing the calls for more studies on the evolving value chains of integrated solutions, mechanisms for inter- and intra-organizational integration and subsequent value creation in project networks have been explored. The research results in thirteen integration mechanisms and a typology for integration is proposed. Managing integration consists of integrating the project network (the supplier and the sub-suppliers) and the customer (the customer’s business purpose, operations environment and the end-user) into the project by making use of integration mechanisms. The findings bring new insight into research on industrial project business by proposing integration of technology and engineering related elements with elements related to customer oriented business performance in contemporary project environments. Thirteen mechanisms for combining products and the processes needed to deliver projects are described and categorized according to the impact that they have on the management of knowledge and information. These mechanisms directly relate to the performance of the supplier, and consequently to the functioning of the solution that the project provides. This thesis offers ways to promote integration of knowledge and information during the lifecycle of industrial projects, enhancing the development towards innovative solutions in project business.

Kirurgisten potilasohjeiden laatu ja valmius tukea voimavaraistavaa potilasohjausta sekä infektioiden torjuntaan liittyvä sisältö

Hoitotyössä infektioiden torjunnan painopistealueena on ollut lisätä potilaiden osallistuvuutta voimavaraistavalla potilasohjauksella. Potilasohjauksen apuna käytetään usein kirjallisia potilasohjeita, joiden rakenne ja laatu tulee olla hyvä. Lisäksi potilasohjeiden tulee omata valmiuksia tukea voimavaraistavaa potilasohjausta. Kirjalliset potilasohjeet ovat hyvä potilasohjauksen keino, mutta systemaattinen tieto potilasohjeiden laadusta, valmiuksista tukea voimavaraistavaa potilasohjausta sekä infektioiden torjunnan sisällöstä puuttuu. Tutkimuksen tarkoituksena oli analysoida Suomen yliopistosairaaloiden kirurgisten potilasohjeiden infektioiden torjuntaan liittyvää sisältöä. Lisäksi oltiin kiinnostuneita potilasohjeiden laadusta hyvien kirjallisten potilasohjeiden ominaispiirteiden toteutumisessa sekä potilasohjeiden valmiuksista tukea voimavaraistavaa potilasohjausta. Tutkimuksen aineistona oli viiden yliopistosairaalan kirurgisille aikuispotilaille tarkoitetut potilasohjeet (N = 237). Organisaatioittain joka viides potilasohje (n = 50) analysoitiin potilasohjeiden laadun osalta sisällönerittelyllä ja aikaisemmin kehitetyn mittarin avulla (Salanterä ym. 2004). Deduktiivisella sisällönanalyysillä analysoitiin potilasohjeiden valmiuksia tukea voimavaraistavaa potilasohjausta, jonka ulottuvuuksien esiintyvyyden arviointiasteikko oli kehitetty tätä tutkimusta varten. Induktiivisella sisällönerittelyllä analysoitiin infektioiden torjuntaan liittyvä sisältö. Potilasohjeiden laadussa oli paljon vaihtelua, ja vain 36 % (n = 18) potilasohjeista oli julkaistu viimeisen kolmen vuoden (2010–2012) aikana. Potilasohjeet olivat ulkoasultaan selkeitä ja johdonmukaisia, jolloin kirjallisten potilasohjeiden ominaisuuksista parhaiten toteutuivat ulkoasun sekä kielen ja rakenteen ominaisuudet. Potilasohjeet kuvasivat toimenpidettä ja siitä selviytymistä, antaen parhaiten valmiuksia tukea toiminnallista ja bio-fysiologista selviytymistä potilasohjauksella. Infektioiden torjuntaan liittyvä sisältö oli pääasiassa esitetty epäsuorasti toisen asian kautta. Infektioiden syntyyn tai torjuntaan ei viitattu, vaan asiaa tarkasteltiin muusta näkökulmasta esimerkiksi ylipainon ja ihon kunnon osalta. Yleisin infektioiden torjuntaan liittyvä sisältö koski käsihygieniaa, vaikka sen toteuttamista ei opastettu tai ohjeistettu. Tutkimus tarjoaa lähtökohdan kehittää potilasohjeiden infektioiden torjuntaan liittyvää sisältöä sekä potilaan osallistuvuuden lisäämistä. Erityisesti tulisi kehittää potilaan osallistuvuuden tukemista voimavaraistavalla potilasohjauksella. Jatkotutkimuksena tulisi kartoittaa potilaiden tarpeet infektioiden torjunnan sisällöstä sekä kehittää kansallinen ohjeistus potilasohjeiden infektioon torjuntaan liittyvästä sisällöstä ja rakenteesta.

Receptors and endocytosis of coxsackievirus A9

Coxsackievirus A9 (CV-A9) belongs to human enteroviruses within family Picornaviridae, which are the main cause of aseptic meningitis. In addition, CV-A9 causes a wide range of other clinical manifestations of acute disease including respiratory infections, myocarditis, encephalitis and severe generalized infections in newborns. In this study, the functions of integrins αVβ6 and αVβ3 in the attachment and cellular entry of CV-A9 were analyzed. Further, virus and cell surface interactions and endocytosis of CV-A9 were studied in specific cell lines. Also, a method for production of GFP-expressing CV-A9 particles by long PCR-mediated mutagenesis and in vivo transcription was developed. The results indicated that RGD-motif (arginine-glycine-asparagine) that resides in the viral capsid is important for CV-A9 infection particularly in cell lines expressing integrin αVβ6 and that this integrin serves as a high affinity attachment receptor for the virus. CV-A9 is also capable of infecting certain cell lines independently of αV-integrins by binding to the cell surface HSPA5 protein. Regardless of the attachment stage, the internalization of the virus occurs via the same entry pathway and is dependent on β2M, dynamin, and Arf6 but independent of clathrin and caveolin-1. Furthermore, the virus internalization occurs within Arf6-containing vesicles suggesting that Arf6 is central mediator of CV-A9 endocytosis. While in this study the results of CV-A9 endocytosis were based on microscopical visualization within individual fixed cells, a rapid method for generation of a virus for real-time imaging was also described.

Understanding, Managing And Developing A Well-Being Service Brand

The aim of this study is to analyze and understand a well-being service brand. Brands most definitely are a hot topic of today’s business world. Companies have started to realize the importance of branding, especially when talking about product related industries. Branding of services is a relatively new concept, which has gained less attention within academic literature. Though there is no legal distinction between product and service brands, they both have their own characteristics and qualities. The focus of the study is especially on the current brand images of both internal and external stakeholder groups. Understanding these brand perceptions will help in managing and developing the brand, so that it becomes even stronger, more recognized, and unified. This study is a quantitative, semi hypothetic-deductive single case study. The data for this study was collected throughout an online survey. The respondents represent both internal stakeholders, in direct contact with the service, as well as external stakeholders, who have no previous history with the service brand. The respondents represent a wide age spread, and are also geographically diverse. The study relies on a Finnish context. The study provides numerous managerial takeaways, especially because of its wide scope, on a topic that has never before been studied. All findings strongly reflected existing service brand theory, in addition with making the findings implementable for the case company.