Delivery of European Cross-Border Health Care and the Relevance and Effects of EU Regulations and Judicial Processes with Reference to Delivery of Drugs and Blood Donor Information Material.

Valtion rajat ylittävät terveyspalvelut Euroopan unionissa sekä Euroopan unionin säädösten merkitys ja vaikutus erityisesti lääkejakeluun ja verenluovuttajille jaettavaan tiedotusaineistoon Valtion rajat ylittävä terveydenhuolto on suuren kiinnostuksen kohteena Euroopan unionissa. Resurssien hyödyntäminen parhaalla mahdollisella tavalla ja tiedon keskittäminen ovat tarpeen terveydenhuollon kustannusten alati noustessa. Terveydenhuoltopalvelut kuuluvat Euroopan sisämarkkinoiden vapaan liikkuvuuden piiriin. Euroopan unionilla ei ole kuitenkaan toimivaltaa säädellä terveydenhuoltojärjestelmiä, vaan sen mahdollisuudet ovat enimmäkseen kansanterveyden edistämisessä ja suojelussa, myös muilla toimialueilla kuin terveydenhuollossa. Tutkimuksen tavoitteena oli tutkia Euroopan unionin säädösten vaikutusta terveydenhuoltosektoriin, erityisesti valtion rajat ylittäviin terveydenhuoltopalveluihin. Erityiskohteena olivat lääkemääräyksen toimittaminen toisen Euroopan unionin jäsenmaan apteekista, resepti-lääkkeiden maahantuonti omaan henkilökohtaiseen käyttöön, sähköisen lääkemääräyksen käyttö kansallisesti ja mahdollisuudet sen käyttöön eri jäsenmaiden välillä, online-apteekkien soveltuvuus Euroopan unionin sisämarkkinoille sekä verenluovuttajille jaettavan tiedotusaineiston yhtenäistämistarve Euroopan unionin alueella. Tutkimuksen osa-alueiden aineisto koottiin vuosina 1999–2003, jolloin Euroopan unioniin kuului 15 jäsenmaata. Apteekit toimittivat useimmiten myös ei-kansalliset, toisessa Euroopan unionin jäsenmaassa annetut lääkemääräykset. Kaikki jäsenmaat rajoittivat lääkemääräyksen vaativien lääkkeiden maahantuontia. Rajoituksia oli maahantuontimäärissä ja -tavoissa. Lisäksi sairasvakuutuskorvausten saaminen ulkomailla lunastetuista reseptilääkkeistä oli hankalaa. Sähköiset lääkemääräykset olivat käytössä vain kahdessa maassa, mutta useissa maissa suunniteltiin niiden kokeilua. Standardit ja käyttöjärjestelmät olivat erilaisia eri maissa. Euroopan unionin alueelle on perustettu online-apteekkeja, joiden toiminta on kuitenkin vaatimatonta. Verenluovuttajille annettava tiedotusaineisto ei missään maassa täyttänyt veridirektiivin vaatimuksia. Tutkimuksen tulokset osoittivat kansallisten käytäntöjen eroavaisuuksien rajoittavan valtion rajat ylittäviä terveydenhuoltopalveluita. Vaikka Euroopan unionin tavoitteena ei ole yhtenäistää terveydenhuoltojärjestelmiä, on tarpeen arvioida uudelleen unionin ja jäsenmaiden välistä työnjakoa. Kansalliset terveydenhuoltojärjestelmät eivät ole erillään Euroopan sisämarkkinoista, jotka merkittävästi vaikuttavat terveydenhuoltoon.

Leda förändring genom relationer, processer och kultur

Forskningens syfte var att bidra med en ny kunskapssyntes om vad det innebär att leda förändring ur ett vårdvetenskapligt perspektiv. Vårdledaren har, speciellt vid större förändringar inom organisationen, en stor betydelse för hur vårdandet förvaltas genom att hålla den vårdande traditionen levande och genom formningen av den vårdande kulturen och vårdgemenskapen. Den övergripande hermeneutiska forskningsansatsen med tillämpning av metodologisk triangulering har influerats av Gadamers, Ricoeurs och Ödmans syn på hermeneutik med förståelse och förklaring som kompletterar varandra. Forskningens övergripande frågeställning ”Vad innebär det att leda förändring ur ett vårdvetenskapligt perspektiv?” förankrades i de fyra underliggande frågeställningarna. Den första frågeställningen berörde meningsinnehållet i begreppet förändring samt dess gestaltning. Metoden var en hermeneutisk begreppsbestämning på en ontologisk och kontextuell nivå enligt Koorts metod för begreppsbestämning. Genom en personalenkät undersöktes personalens åsikter (totalt 597 personer) om den kommande fusionen och förändringen samt deras förväntningar på ledarna under förändringsprocessen för att få svar på vad förutsättningarna var för en förändring eller förändringsprocess med avsedda mål och effekter. Svaret på hur vårdledaren och dennes uppgifter gestaltades vid en förändring samt hur vårdledarna uppfattade förändring och den kommande förändringsprocessen erhölls genom djupintervjuer med vårdledare (17). Av resultatet framgår att vårdledaren leder förändring genom att leda relationer, processer och kultur och genom ett stödjande, reflekterande och kulturbärande ledarskap med syftet att åstadkomma en verklig och hållbar förändring. För att åstadkomma en verklig och hållbar förändring, dvs. en inre omgestaltning och omdaning som vardande, förutsätts dock att både tankemönster och handlanden förändras. Riktningen och insatserna för förändringen skall ha sin grund i en tydlig och meningsfull målsättning och vision utgående från en gemensam värdegrund. En arena för dialog borde utvecklas så att förändringens liksom även vårdandets vision och mission förankras och utvecklas till handling och förändring. Vårdledarens primära uppgift eller mission var att tillhandahålla varje individuell patient en god vård. Den primära missionen var med andra ord att med ansvarsfullhet tjäna vårdandet sak utgående från ett etiskt förhållningssätt. I tjänande av vårdandets sak fanns dock en tillit till att förändringen gagnar patienten och hans eller hennes vård, men vårdledarnas anpassning till förändringen var utan djupare engagemang. Vårdledarna kände även en oro för sitt uppdrag som vårdledare, vårdarbetets ställning och mandatet som patientens advokat. Vårdledaren är också en kulturbärare, vilket innebär att även kulturen har betydelse under en förändringsprocess. Genom att leda kulturen skapar vårdledaren en öppen, bekräftande och evidensbaserad atmosfär med centrala värderingar som ger uttryck för den rådande andan och kulturen.

OpenAIRE Guidelines for Literature Repositories, Data Archives and CRIS managers

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

Making SHERPA/FACT Local

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

Data Management [in eprints] for arts research: the experience at University of the Arts London

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

Biodiversity Heritage Library: a global open repository

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

“Who is steering the ship and which constellation guides the way? Exploring transparency in the European Central Bank during the time of crisis”

This paper explores transparency in the decision-making of the European Central Bank (ECB). According to ECB´s definition, transparency means that the central bank provides the general public with all relevant information on its strategy, assessments and policy decisions as well as its procedures in an open, clear and timely manner. In this paper, however, the interpretation of transparency is somewhat broader: Information is freely available and directly accessible to those who will be affected by the decisions. Moreover, the individuals shall be able to master this material. ECB´s negative attitude towards publication of documents has demonstrated central bank´s reluctance to strive towards more extensive transparency. By virtue of the definition adopted by the ECB the bank itself is responsible for determining what is considered as relevant information. On the grounds of EU treaties, this paper assesses ECB`s accountability concentrating especially on transparency by employing principal-agent theory and constitutional approach. Traditionally, the definite mandate and the tenet of central bank independence have been used to justify the limited accountability. The de facto competence of the ECB has, however, considerably expanded as the central bank has decisively resorted to non-standard measures in order to combat the economic turbulences facing Europe. It is alleged that non-standard monetary policy constitutes a grey zone occasionally resembling economic policy or fiscal policy. Notwithstanding, the European Court of Justice has repeatedly approved these measures. This dynamic interpretation of the treaties seems to allow temporarily exceptions from the central bank´s primary objective during extraordinary times. Regardless, the paper suggests that the accountability nexus defined in the treaties is not sufficient in order to guarantee the accountability of the ECB after the adoption of the new, more active role. Enhanced transparency would help the ECB to maintain its credibility. Investing in the quality of monetary dialogue between the Parliament and the ECB appears to constitute the most adequate and practicable method to accomplish this intention. As a result of upgraded transparency the legitimacy of the central bank would not solely rest on its policy outputs.

Le relazioni Italo - Finlandesi nella documentazione del Ministero degli Affari Esteri italiano e nel "Memoriale" di Attilio Tamaro (1929-1935)

My doctoral thesis may be placed within the branch of studies on the history of international relations and it examines the development of Italian-Finnish bilateral relations during the mandate of Attilio Tamaro, the plenipotentiary Minister (1929-1935). The research is based exclusively on Italian sources, on the private documentation of the diplomat and on his “Memoriale”, which have been critically analysed, using theories, such as those on the policies of power, on the soft power and on foreign trade. This research aims to draw attention to the bilateral dynamics, and to bridge the gaps of the specific historiography, paying attention to the relations between the Lapua movement and Italian fascism, and to the role that the Minister Tamaro played. The 1929-1935 period is the most intense one in the bilateral relations, and it expands those already begun in the Twenties, thereby replacing the idea of a poor and backward Italy with that of a modern, strong and orderly country that fascism had been capable of building. The need for Finland to solve its internal problems led to the development of the lappist movement in the first few months of 1930 which, with its anticommunism and anti-parliamentarism, led conservative Finland to look towards the Italian political model with particular fondness. The Italian diplomacy, at least during the Grandi ministry, distinguished itself for its moderate involvement in its connections with lappism. After 1932, with the spread of universal fascism, opposing national-socialism, the relationships between fascism and the lappist movement intensified and led the IKL (Patriotic People’s Movement) into the Italian sphere. Actually, especially after 1933, what was the most effective instrument of Tamaro’s political action was culture: the Italian Readership, the cultural associations, and the use of the cinematic arts and art were the channels for the expansion of a cultural imperialism which abounded in political propaganda. With the War of Ethiopia in 1935, the good Italian-Finnish relationships partly cooled down because Italy appeared to be a dangerous nation for the stability of the security system of Finland. The research results are stimulating: they bring to light the ambitions of great power of monarchist-fascist Italy; they show the importance of the Italian example in inspiring the conservative Finnish right-wing; they allow one to hypothesize that there was at least an indirect influence of the Italian model on the development of Finnish events. The aspiration of our research is to stimulate further studies on diplomatic, military and trade relations between Italy and the Scandinavian countries from 1919 to today.

THE NETWORK EMBEDDEDNESS OF A FOREIGN SALES SUBSIDIARY The subsidiary personnel perspective

This study focuses on the network embeddedness of a subsidiary of a multinational company. Academic research has identified the rising role of geographically dispersed subsidiaries as valuable sources of strategic knowledge and value to the whole multinational company. Moreover, previous research suggests that in order to gather this knowledge and transfer it across the multinational company, a subsidiary needs to be insider, i.e. embedded, in both its local external network as well as in its internal corporate network. The purpose of this study is to describe the network embeddedness of a foreign sales subsidiary from the subsidiary personnel perspective and hence increase understanding on the phenomenon and provide suggestions to enhance overall subsidiary embeddedness. The empirical study was based on a theoretical framework on subsidiary network embeddedness and comprised a qualitative single-case study in a French sales subsidiary of a Nordic multinational company. Data collection included nine semi-structured interviews and six Network Pictures drawing tasks. Altogether eight people out of subsidiary staff of eleven participated in the study providing relatively exhaustive overview of the subsidiary personnel perspective. Based on the collected data, the relationships toward the most relevant network actors, both internal and external were identified and their impact on the subsidiary embeddedness were analyzed separately. Moreover, the subsidiary’s simultaneous embeddedness in both internal and external network, that is, the subsidiary dual embeddedness, was discussed to increase understanding how subsidiary personnel perceive their role between the two networks and its impact on the subsidiary activities. The findings of the study suggest that the subsidiary personnel perceives strong external embeddedness increasing internal and dual-embeddedness since intensive external collaboration requires including and activating other corporate units as well. The role of the local sales subsidiary is to act as the interpreter and connector between the internal and external network actors. Hence, by actively promoting relationship linkages between internal and external actors, the subsidiary may adopt an active role beyond its original corporate mandate. In order to achieve this, both managers on the subsidiary and corporate level need to promote open communication and increase cultural understanding between different corporate units.