Evaluation of novel programs in health counseling – their effectiveness in the oral health of young children, and their acceptance by parents and professionals in public dental service.

Aim and design: To evaluate family-based health counseling for young children, and to study the significance of adding parental self-care or the training of professionals to the programs. The effectiveness and acceptability of the programs were evaluated by comparing two new programs with an earlier one. Subjects and methods: The study was carried out in Vantaa, which was divided into three study areas. The subjects consisted of children born in 2008, particularly fi rstborn children, while children born in 2006 formed the historical control. The fi rst of the new programs emphasized oral hygiene and use of fl uoride, and the second program focused on proper diet and use of xylitol. The main outcome measure was mutansstreptococci (MS) in the dental biofi lm of two-year-olds, and the opinions of parents and dental professionals were evaluated using questionnaires. Results: The programs found wide acceptance among dental professionals. There were no group-related differences found in the MS scores of the two-year-olds. However, all groups combined, father’s advanced level of education and child’s proper use of xylitol were associated with negative MS scores. In the opinion of parents, the oral healthcare guidance at least somewhat met their expectations. Conclusions: The present fi ndings suggest that providing training and support for professionals in health education is important. The addition of parental self-care to supplement programs aimed at young children does not improve the program, although it may improve parental readiness to change their own health habits. Counseling for families might be best carried out through a routine patient-centered program.

Production scheduling tools' evaluation in a global telecommunications and electronics company

Tutkimuksen päätavoite on arvioida, ovatko neljä ohjelmistovaihtoehtoa riittäviä tuotannon aikataulutuksen työkaluja ja mikä työkaluista sopii toimeksiantajayritykselle. Alatavoitteena on kuvata tuotannon aikataulutuksen nyky- ja tahtotila prosessimallinnuksen avulla, selvittää työkalun käyttäjätarpeet ja määritellä priorisoidut valintakriteerit työkalulle.Tutkimuksen teoriaosuudessa tutkitaan tuotannon aikataulutuksen logiikkaa ja haasteita. Työssä tarkastellaan aikataulutusohjelmiston valintaa rinnakkain prosessinmallinnuksen kanssa. Aikataulutusohjelmistovaihtoehdot ja metodit käyttäjätarpeiden selvittämiseksi käydään läpi. Empiriaosuudessa selvitetään tutkimuksen suhde toimeksiantajayrityksen strategiaan. Käyttäjätarpeet selvitetään haastattelujen avulla jaanalysoidaan QFD matriisin avulla. Toimeksiantajayrityksen tuotannon aikataulutuksen nyky- ja tahtotilaprosessit mallinnetaan, jotta ohjelmistojen sopivuutta, aikataulutusprosessia tukevana työkaluna voidaan arvioida.Tutkimustuloksena ovatpriorisoidut valintakriteerit aikataulutustyökalulle eli käyttäjätarpeista johdetut tärkeimmät toiminnalliset ominaisuudet, järjestelmätoimittaja-arvio sekä suositukset jatkotoimenpiteistä ja lisätutkimuksesta.

Guidelines for supplier selection and performance evaluation in the case-company

Tutkielmantavoitteena oli luoda ohjeistus toimittajan valinnasta ja suorituskyvyn arvioinnista case - yrityksen, Exel Oyj:n, käyttöön. Ohjeistuksen tarkoituksena oli ollalähtökohtana toimittajan valinta- ja suoristuskyvyn arviointiprosessien kehittämisessä. Tutkielma keskittyy esittelemään toimittajan valintakriteereitä ja toimittajan suorituskyvyn arviointikriteereitä. Kriteerit valittiin ja analysoitiin teorian ja empirian avulla ja kriteereistä tehtiin selkeät listaukset. Näitä listoja käytettiin avuksi pohdittaessa uusia valintakriteereitä ja suorituskyvyn arviointikriteereitä, joita case -yritys voi jatkossa käyttää. Tutkielmassa käytiin läpi myös toimittajan valintaprosessi jaapuvälineitä ja mittareita toimittajan arviointiin liittyen. Empiirisen aineiston keruu toteutettiin haastattelemalla hankintapäällikköä sekä keräämällä tietoavuosikertomuksesta ja yrityksen internet sivuilta. Tutkielman tuloksena saatiinlistauksia kriteereistä, joita yritys voi hyödyntää jatkossa sekä listaukset kriteereistä, jotka valittiin alustavasti yrityksen käyttöön.

Essays on Innovativeness and its Evaluation in Small and Medium-sized Enterprises

Tutkimus koostuu neljästä artikkelista, jotka käsittelevät suomalaisten pienten ja keskisuurten teollisuusyritysten (PKT-yritysten) innovatiivisuutta, sen attribuutteja (ominaispiirteitä) sekä indikaattoreita. Tutkimuksessa tarkastellaan sekä kirjallisuudessa esitettyjä että PKT-johtajien ja PKT-yritystenkehityshankkeiden rahoituspäätöksiin osallistuvien yritystutkijoiden haastatteluissa esittämiä innovatiivisuuden määritelmiä. Innovatiivisuusindikaattoreista tarkastellaan PKT-yritysten kehittämishankkeille sovellettavia rahoitus- ja arviointikriteerejä sekä yritysten ulkopuolisten rahoittajien että PKT-johtajien näkökulmasta. Erityistä huomiota kohdistetaan sovellettuihin laadullisiin ja ei-numeerisiin innovatiivisuuden arviointikriteereihin. Sekä kirjallisuudessa että kymmenen yritystutkijan ja kuuden esimerkkiyrityksen johtajan haastatteluissa innovaation uutuus yhdistetään innovatiivisuuteen. Muita tärkeitä innovatiivisuuteen liitettyjä ominaisuuksia olivat markkinat, muista yrityksistä erottuminen ja yksilöiden luovuus. Ihmisläheiset ja yksilöihin liittyvät näkökulmat korostuvat yritystutkijoiden ja PKT-johtajien innovatiivisuuden määritelmissä, kun taas kirjallisuudessa annetaan enemmän painoa ympäristölle, tuotteille ja markkinoille. Yritystutkijat pitivät yritykseen ja sen johtajaan liittyviä tekijöitä tärkeinä rahoitettavien kehittämishankkeiden panosten arviointikriteereinä. Tuotteiden kaupallinen menestys oli rahoittajan kannalta tärkein tulostekijä. Tarkastelluissa esimerkkiyrityksissä kehityshankkeista päättäminen ja hankkeiden arviointi on toisaalta intuitiivista ja saattaa olla tiedostamatontakin, koska yritysten kehittämistoiminta on vähäistä. Pienyritysten johtajat korostavat arvioinnissa rahallisiamittareita, vaikka sekä numeerisia että laadullisia kriteereitä sovelletaan. Todennäköisin syy tälle on pienyritysten rajalliset taloudelliset voimavarat. Toinen mahdollinen syy rahoituksellisten tekijöiden painottamiseen on, että tämän päivän ihannejohtaja ymmärretään analyyttiseksi ja mm.rahavirtoja valvovaksi. Kuitenkin innovatiiviset yritysjohtajat pitävät innovaatioiden luomista yhtenä elämän hauskoista puolista. Innovatiiviset esimerkkiyritykset ovat tulevaisuuteen ja kasvuun suuntautuneita strategisella tasolla. Operationaalisella tasolla ne tuottavat keksintöjä ja innovaatioita. Patentteja tarkastelluilla yrityksillä on kuitenkin vähän. Sekä innovatiiviset että vähemmän innovatiiviset esimerkkiyritykset ovat voimakkaasti asiakassuuntautuneita ja erikoistuneita tiettyihin tuotteisiin ja asiakkaisiin. Asiakkaiden tarpeita tyydytetään kehittämällä niitä vastaavia tuotteita. Tästä johtuu, että valtaosa yritysten kehittämistoiminnasta kohdistuu tuotteisiin tai tuotantoon.

Managing Customer Retention in Health and Fitness Club Industry

The objective of this study is to resolve how customer retention is managed in Finnish health and fitness clubs, and how is this comparable with the theoretical aspects of customer retention. It is also discussed how the process leading to customer retention is handled, and what the essential elements of customer retention and loyalty are specifically in the health and fitness club industry. In addition, it is discussed to what extent do health and fitness club companies implement the elements of customer retention in their businesses. Finally, there is discussion about the relationship and priority between the behavioral and attitudinal methods of creating retention in the companies. The data was collected by interviewing the management of six health and fitness clubs from different geographical regions in Finland. Results indicated that the most important constructs concerning customer retention were switching barriers, pricing strategy, competitive aspect, corporate image, service quality, employee retention, and customer satisfaction. In addition, the implementation of customer retention was found to vary between different sized companies and companies from different geographical locations. Moreover, it was discovered that the companies put more effort in constructs that are considered to create customer loyalty instead of retention.

Utilizing Near Field Communication in Health Care

In this master’s thesis, possibilities to utilize Near Field Communication (NFC) technology in health care applications are examined. NFC is a short-range wireless communication technology that enables the exchange of data between devices. Main components in NFC are tag, which contains data, a NFC reader device, which can be for instance embedded to mobile phone and also act as a tag, and an antennae in both tag and reader. In this work NFC technology is discussed and its utilization in health care information systems that are in use or in trial. Utilization of information technology in health care field is examined superficially. In this thesis, a system utilizing NFC is designed and its requirements and architecture presented. NFC is used in identification of care worker. When care worker arrives at the house of a patient, she brings the NFC-enabled mobile phone near NFC tag. This sends information to the application server. This information contains the time of arrival and patient and location identifier. When care worker leaves the place, she repeats the procedure. Information gathered can be used in reporting and real time tracking.

Strategic Change Management Readiness Evaluation in Organizations

The objective of this study and paper was to find out how the strategic change management readiness in organizations can be evaluated. Based on theory and prior CMP model, the framework of strategic change management and issues related to it was constructed. Additionally a synthesis of the most important phases and interventions in strategic change process and project was created. These phases were starting point, planning, implementation and evaluation and securing phases. Qualitative approach was utilized in the empirical part of the study due to the need for in-depth information about the topics surveyed through semi-structured interview. There were 18 responders from the top management of large Finnish companies. In this study interventions, strengths and weaknesses during the various phases of strategic change projects were revealed. Additionally the interviewees’ opinion on the importance of each of the interventions in strategic change project success was asked. According to this study, the most important phases recognized through researching theoretical literature, prior CMP model and empirical information in starting point phase were analysis of current and desired state and need for change accompanied with guiding coalition formulation. In planning phase the most important interventions were project organization formulation, action plan creation, analysis of prior and current strategic change projects and organizational structure analysis. In the change project implementation phase the interventions of importance were launch, quick wins, sense of urgency creation, change resistance management and change communications. In the final evaluation and securing phase project evaluation was the most important intervention. Based on the results a tool for creating change management readiness profile was created.

Towards Perfection Step by Step – User Experience Design and Evaluation in the Context of Digital Libraries

Heli Kautonen's presentation in the LIBER Conference 27 June, 2013 in Munich, Germany.

Supplier Delivery Quality Evaluation in Maintenance Supporting Spare Part Business

The focus of this thesis is the issues related to the operational purchasing level supply chain process. Due to this limitation, the physical product quality issues do not belong to the primary concerns of this thesis, whereas the bilateral processes between the supplier and the purchasing organizations are of interest. Also, the issues related to the delivery timing are excluded from the study. Because the perspective is on the issues involved in the supply chain operations, the bilateral communication issues between supplier representative and purchaser are also considered.

Early Life Intestinal Microbiota in Health and in Atopic Eczema

Decrease in microbial contacts in affluent societies is considered to lie behind the rise in allergic and other chronic inflammatory diseases during the last decades. Indeed, deviations in the intestinal microbiota composition and diversity have been associated with several diseases, such as atopic eczema. However, there is no consensus yet on what would constitute a beneficial or harmful microbiota. The aim of this thesis was to study the microbiota development in healthy infants and to characterize intestinal microbiota signatures associated with disease status and severity in infants with atopic eczema. The methodological aim was to compare and optimize methods for DNA extraction from fecal samples to be used in high-throughput microbiota analyses. It was confirmed that the most critical step in successful microbial DNA extraction from fecal samples is the mechanical cell lysis procedure. Based on this finding, an efficient semi-automated extraction process was developed that can be scaled for use in high-throughput platforms such as phylogenetic microarray used in this series of studies. By analyzing a longitudinal motherchild cohort for 3 years it was observed that the microbiota development is a gradual process, where some bacterial groups reach the degree of adult-type pattern earlier than others. During the breast-feeding period, the microbiota appeared to be relatively simple, while major diversification was found to start during the weaning process. By the age of 3 years, the child’s microbiota composition started to resemble that of an adult, but the bacterial diversity has still not reached the full diversity, indicating that the microbiota maturation extends beyond this age. In addition, at three years of age, the child’s microbiota was more similar to mother’s microbiota than to microbiota of nonrelated women.In infants with atopic eczema, a high total microbiota diversity and abundance of butyrate-producing bacteria was found to correlate with mild symptoms at 6 months. At 18 months, infants with mild eczema had significantly higher microbiota diversity and aberrant microbiota composition when compared to healthy controls at the same age. In conclusion, the comprehensive phylogenetic microarray analysis of early life microbiota shows the synergetic effect of vertical transmission and shared environment on the intestinal microbiota development. By the age of three years, the compositional development of intestinal microbiota is close to adult level, but the microbiota diversification continues beyond this age. In addition, specific microbiota signatures are associated with the existence and severity of atopic eczema and intestinal microbiota seems to have a role in alleviating the symptoms of this disease.

Modularity in Health and Social Services: Perspectives on Organization and Management

Organizations that provide health and social services operate in a complex and constantly changing environment. Changes occur, for example, in ageing, technology and biotechnology, and customers’ expectations, as well as the global economic situation. Organizations typically aim to adapt the changes by introducing new organizational structures and managerial practices, such as process and lean management. Only recently has there been an interest in evaluating whether organizations providing health and social services could apply modularity in order to respond to some of the changes. The concept of modularity originates from manufacturing, but is applied in many other disciplines, such as information technology and logistics. However, thus far, the literature concerning modularity in health and social services is scarce. Therefore the purpose of this thesis is to increase understanding concerning modularity and the possibilities to apply modularity in the health and social services context. In addition, the purpose is to shed light on the viewpoints that are worth taking into account when considering the application of modularity in the health and social services context. The aim of the thesis is to analyze the way in which the modular structures are applied in the health and social services context and to analyze what advantages and possible barriers, as well as managerial concerns, might occur if modularity is applied in the health and social services context. The thesis is conducted by using multiple methods in order to provide a broad aspect to the topic. A systematic literature review provided solid ground for pre-understanding the topic and supported the formulation of the research questions. Theoretical reasoning provided a general overview of the special characteristics of the health and social services context and their effect on application of modularity. Empirical studies concentrated on managerial concerns of modularity particularly from the perspective of health and social services for the elderly. Results of the thesis reveal that structures in products, services, processes, and organizations are rather modular in health and social services. They can be decomposed in small independent units, while the challenges seem to occur especially in the compatibility of the services. It seems that health and social services managers have recognized this problem and they are increasingly paying attention to this challenge in order to enhance the flexible compatibility of services. Advantages and possible barriers of modularity are explored in this thesis, and from the theoretical perspective it could be argued that modularity seems to be beneficial in the context of health and social services. In fact, it has the potential to alleviate several of the challenges that the health and social services context is confronting. For example, modular structures could support organizations in their challenging task to respond to customers’ increasing demand for heterogeneous services. However, special characteristics of the health and social services context create barriers and provide significant challenges in application of modularity. For example, asymmetry of information, negative externalities, uncertainty of demand, and rigid regulation prevent managers from extensively drawing benefits from modularity. Results also reveal that modularity has managerial implications in health and social service. Modularity has the potential to promote and support new service development and outsourcing. Results also provide insights into network management and increases managerial understanding of different network management strategies. Standardization in health and social services is extensive due to legislation and recommendations. Modularity provides alternative paths to take an advantage of standardization while still ensuring the quality of the services. Based on this thesis, it can be concluded, both from a theoretical perspective and from empirical results concerning modularity in health and social services, that modularity might fit well and be beneficial. However, the special characteristics of the health and social services context prevent some of the benefits of modularity and complicate its application. This thesis contributes to the academic literature on the organization and management of health and social services by describing modularity as an alternative way for organizing and managing health and social services. In addition, it contributes to the literature of modularity by exploring the applicability of modularity in the context of health and social services. It also provides practical contribution to health and social services managers by evaluating the pros and cons of modularity when applied to health and social services.

The importance of environmental sustainability in public procurement of medical devices in health care sector

The aim of this thesis was to examine the role of environmental sustainability in the procurement of medical devices in health care sector. Current literature is mainly focused on other product groups and medical devices have been left without sufficient attention. Nevertheless, EU has recently developed green public procurement criteria for medical devices (EU GPP criteria for health care EEE) in order to support and offer guidelines for purchasers in hospitals. In this study, the criteria were used as a framework in order to examine the most significant environmental aspects for medical devices. The empirical research was executed in Finnish public hospitals with mixed method approach; quantitative data was collected by a survey and qualitative data was collected by interviews held for procurement specialists. The focus was on understanding the importance of environmental sustainability in the procurement of medical devices and which environmentally sustainable features would be the most significant. Of interest was also the medical device supplier view and how they could take environmental sustainability into consideration.

Characterizing Propionibacterium freudenreichii ssp. shermanii JS and Lactobacillus rhamnosus LC705 as a new probiotic combination: basic properties of JS and pilot in vivo assessment of the combination

Characterizing Propionibacterium freudenreichii ssp. shermanii JS and Lactobacillus rhamnosus LC705 as a new probiotic combination: basic properties of JS and pilot in vivo assessment of the combination Each candidate probiotic strain has to have the documentation for the proper identification with current molecular tools, for the biological properties, for the safety aspects and for the health benefits in human trials if the intention is to apply the strain as health promoting culture in the commercial applications. No generalization based on species properties of an existing probiotic are valid for any novel strain, as strain specific differences appear e.g. in the resistance to GI tract conditions and in health promoting benefits (Madsen, 2006). The strain evaluation based on individual strain specific probiotic characteristics is therefore the first key action for the selection of the new probiotic candidate. The ultimate goal in the selection of the probiotic strain is to provide adequate amounts of active, living cells for the application and to guarantee that the cells are physiologically strong enough to survive and be biologically active in the adverse environmental conditions in the product and in GI tract of the host. The in vivo intervention studies are expensive and time consuming; therefore it is not rational to test all the possible candidates in vivo. Thus, the proper in vitro studies are helping to eliminate strains which are unlikely to perform well in vivo. The aims of this study were to characterize the strains of Propionibacterium freudenreichii ssp. shermanii JS and Lactobacillus rhamnosus LC705, both used for decades as cheese starter cultures, for their technological and possible probiotic functionality applied in a combined culture. The in vitro studies of Propionibacterium freudenreichii ssp. shermanii JS focused on the monitoring of the viability rates during the acid and bile treatments and on the safety aspects such as antibiotic susceptibility and adhesion. The studies with the combination of the strains JS and LC705 administered in fruit juices monitored the survival of the strains JS and LC705 during the GI transit and their effect on gut wellbeing properties measured as relief of constipation. In addition, safety parameters such as side effects and some peripheral immune parameters were assessed. Separately, the combination of P. freudenreichii ssp. shermanii JS and Lactobacillus rhamnosus LC705 was evaluated from the technological point of view as a bioprotective culture in fermented foods and wheat bread applications. In this study, the role ofP. freudenreichii ssp. shermanii JS as a candidate probiotic culture alone and in a combination with L. rhamnosus LC705 was demonstrated. Both strains were transiently recovered in high numbers in fecal samples of healthy adults during the consumption period. The good survival through the GI transit was proven for both strains with a recovery rate from 70 to 80% for the JS strain and from 40 to 60% for the LC705 strain from the daily dose of 10 log10 CFU. The good survival was shown from the consumption of fruit juices which do not provide similar matrix protection for the cells as milk based products. The strain JS did not pose