Nursing Ethics Education in Finland from the Perspective of Codes of Ethics

The purpose of this study was to analyze nursing ethics education from the perspective of nurses’ codes of ethics in the basic nursing education programmes in polytechnics in Finland with the following research questions: What is known about nurses’ codes in practice and education, what contents of the codes are taught, what teaching and evaluation methods are used, which demographic variables are associated with the teaching, what is nurse educators’ adequacy of knowledge to teach the codes and nursing students’ knowledge of and ability to apply the codes, and what are participants’ opinions of the need and applicability of the codes, and their importance in nursing ethics education. The aim of the study was to identify strengths and possible problem areas in teaching of the codes and nursing ethics in general. The knowledge gained from this study can be used for developing nursing ethics curricula and teaching of ethics in theory and practice. The data collection was targeted to all polytechnics in Finland providing basic nursing education (i.e. Bachelor of Health Care). The target groups were all nurse educators teaching ethics and all graduating nursing students in the academic year of 2006. A total of 183 educators and 214 students from 24 polytechnics participated. The data was collected using a structured questionnaire with four open-ended questions, designed for this study. The data was analysed by SPSS (14.0) and the open-ended questions by inductive content analysis. Descriptive statistics were used to summarize the data. Inferential statistics were used to estimate the differences between the participant groups. The reliability of the questionnaire was estimated with Cronbach’s coefficient alpha. The literature review revealed that empirical research on the codes was scarce, and minimal in the area of education. Teaching of nurses’ codes themselves and the embedded ethical concepts was extensive, teaching of the functions of the codes and related laws and agreements was moderate, but teaching of the codes of other health care professions was modest. Issues related to the nurse-patient relationship were emphasised. Wider social dimensions of the codes were less emphasized. Educators’ and students’ descriptions of teaching emphasized mainly the same teaching contents, but there were statistically significant differences between the groups in that educators assessed their teaching to be more extensive than what students had perceived it had been. T he use of teaching and evaluation methods was rather narrow and conventional. However, educators’ and students’ descriptions of the used methods differed statistically significantly. Students’ knowledge of the codes and their ability to apply them in practice was assessed as mediocre by educators and by students themselves. Most educators assessed their own knowledge of the codes as adequate to teach the codes, as did most of the students. Educators who regarded their knowledge as adequate taught the codes more extensively than those who assessed their knowledge as less adequate. Also students who assessed their educators’ knowledge as adequate perceived the teaching of the codes to be more extensive. Otherwise educators’ and students’ demographic variables had little association with their descriptions of the teaching. According to the participants, nurses need their own codes, and they are also regarded as applicable in practice. The codes are an important element in nursing ethics education, but their teaching needs development. Further research should focus on the organization of ethics teaching in the curricula, the teaching process, and on the evaluation of the effectiveness of ethics education and on educators’ competence. Also the meaning and functions of the codes at all levels of nursing deserve attention. More versatile use of research methods would be beneficial in gaining new knowledge.

The flow of reality’s development: from postmodernism to post-postmodernism in John Irving’s The World According to Garp and Last Night in Twisted River

In this master’s thesis, I examine the development of writer-characters and metafiction from John Irving’s The World According to Garp to Last Night in Twisted River and how this development relates to the development of late twentieth century postmodern literary theory to twenty-first century post-postmodern literary theory. The purpose of my study is to determine how the prominently postmodern feature metafiction, created through the writer-character’s stories-within-stories, has changed in form and function in the two novels published thirty years apart from one another, and what possible features this indicates for future post-postmodern theory. I establish my theoretical framework on the development of metafiction largely on late twentieth-century models of author and authorship as discussed by Roland Barthes, Wayne Booth and Michel Foucault. I base my close analysis of metafiction mostly on Linda Hutcheon’s model of overt and covert metafiction. At the end of my study, I examine Irving’s later novel through Suzanne Rohr’s models of reality constitution and fictional reality. The analysis of the two novels focuses on excerpts that feature the writer-characters, their stories-within-stories and the novels’ other characters and the narrators’ evaluations of these two. I draw examples from both novels, but I illustrate my choice of focus on the novels at the beginning of each section. Through this, I establish a method of analysis that best illustrates the development as a continuum from pre-existing postmodern models and theories to the formation of new post-postmodern theory. Based on my findings, the thesis argues that twenty-first century literary theory has moved away from postmodern overt deconstruction of the narrative and its meaning. New post-postmodern literary theory reacquires the previously deconstructed boundaries that define reality and truth and re-establishes them as having intrinsic value that cannot be disputed. In establishing fictional reality as self-governing and non-intrudable, post-postmodern theory takes a stance against postmodern nihilism, which indicates the re-founded, non-questionable value of the text’s reality. To continue mapping other possible features of future post-postmodern theory, I recommend further analysis solely on John Irving’s novels’ published in the twenty-first century.

Confronting a victim of intimate partner violence in nursing care : a literature review

Intimate partner violence is a growing problem in health care. The purpose of this thesis was to find ways of confronting a victim of intimate partner violence in nursing care and methods how nurses can encourage the victim to disclose the abuse. The aim of this thesis was to help the health care professionals to understand the issue and the need of the victims better, and that way provide a better care. This thesis is a literature review of previously made research articles about intimate partner violence. The research material consisted of 10 published articles, which were collected from different databases. The articles were published within 10 years. A content analysis method was used to examine the articles by making descriptive summary tables according to each questions. The results of this study showed multiple factors which the health care providers should take into consideration when caring the patients. Asking with a non-judgemental attitude, in a safe, confidential setting without the partner present and prioritizing the abuse was mentioned to be important for the victims. Routinely screening and different kind of brochures was considered as good methods to encourage the victims to disclose the abuse. The need for better training and counselling of the health care providers was also discovered. The results of this thesis, did answer to the chosen study questions and that way the purpose of the thesis was filled. Hopefully, in the future this problem can be minimized and prevented in advanced. Further studies are needed to examine whether these caring methods are actually being used in clinical settings and do they have any effect.

New directions in Stochastic Multicriteria Acceptability Analysis

Decisions taken in modern organizations are often multi-dimensional, involving multiple decision makers and several criteria measured on different scales. Multiple Criteria Decision Making (MCDM) methods are designed to analyze and to give recommendations in this kind of situations. Among the numerous MCDM methods, two large families of methods are the multi-attribute utility theory based methods and the outranking methods. Traditionally both method families require exact values for technical parameters and criteria measurements, as well as for preferences expressed as weights. Often it is hard, if not impossible, to obtain exact values. Stochastic Multicriteria Acceptability Analysis (SMAA) is a family of methods designed to help in this type of situations where exact values are not available. Different variants of SMAA allow handling all types of MCDM problems. They support defining the model through uncertain, imprecise, or completely missing values. The methods are based on simulation that is applied to obtain descriptive indices characterizing the problem. In this thesis we present new advances in the SMAA methodology. We present and analyze algorithms for the SMAA-2 method and its extension to handle ordinal preferences. We then present an application of SMAA-2 to an area where MCDM models have not been applied before: planning elevator groups for high-rise buildings. Following this, we introduce two new methods to the family: SMAA-TRI that extends ELECTRE TRI for sorting problems with uncertain parameter values, and SMAA-III that extends ELECTRE III in a similar way. An efficient software implementing these two methods has been developed in conjunction with this work, and is briefly presented in this thesis. The thesis is closed with a comprehensive survey of SMAA methodology including a definition of a unified framework.

Peso problem anddevaluation expectations: Evidence from Latin America

Tämän tutkielman tavoitteena on tutkia peso-ongelmaa sekä devalvaatio-odotuksia seuraavissa Latinalaisen Amerikan maissa: Argentiina, Brasilia, Costa Rica, Uruguay ja Venezuela. Lisäksi tutkitaan, onko peso-ongelmalla mahdollista selittää korkojen epäsäännöllistä käyttäytymistä ennen todellisen devalvaation tapahtumista. Jotta näiden tutkiminen olisi mahdollista, lasketaan markkinoiden odotettu devalvaation todennäköisyys tutkittavissa maissa. Odotettu devalvaation todennäköisyys lasketaan aikavälillä tammikuusta 1996 joulukuuhun 2006 käyttäen kahta erilaista mallia. Korkoero-mallin mukaan maiden välisestä korkoerosta on mahdollista laskea markkinoiden devalvaatio-odotukset. Toiseksi, Probit-mallissa käytetään useita makrotaloudellisia tekijöitä selittävinä muuttujina laskettaessa odotettua devalvaation todennäköisyyttä. Lisäksi tutkitaan, miten yksittäisten makrotaloudellisten muuttujien kehitys vaikuttaa odotettuun devalvaation todennäköisyyteen. Empiiriset tulokset osoittavat, että tutkituissa Latinalaisen Amerikan maissa oli peso-ongelma aikavälillä tammikuusta 1996 joulukuuhun 2006. Korkoero-mallin tulosten mukaan peso-ongelma löytyi kaikista muista tutkituista maista lukuun ottamatta Argentiinaa. Vastaavasti Probit-mallin mukaan peso-ongelma löytyi kaikista tutkituista maista. Tulokset osoittavat myös, että korkojen epäsäännöllinen kehitys ennen varsinaista devalvaatiota on mahdollista selittää peso-ongelmalla. Probit-mallin tulokset osoittavat lisäksi, että makrotaloudellisten muuttujien kehityksellä ei ole mitään tiettyä kaavaa liittyen siihen, kuinka ne vaikuttavat markkinoiden devalvaatio-odotuksiin Latinalaisessa Amerikassa. Pikemmin vaikutukset näyttävät olevan maakohtaisia.

The effect of oxygen delignification on fiber properties in kraft pulp production - a review

Fiber damages comprise fiber deformations, characterized as fiber curl, kink, dislocations and strength losses as well as some yet unidentified factors. This recently discovered phenomenon is especially evident in mill scale kraftpulps. Laboratory produced pulps tend to have less damages and superior strength properties compared to those produced in pulp mills. Generally fiber damages pose a problem in the production of reinforcement pulp because they tend to decrease the ability of fibers to transmit load. Previous studies on fiber damage have shown that most of the fiber damages occur during brown stock processing starting from cooking and discharging. This literature review gives an overall picture on fiber damages occurring during softwood kraft pulp production with an emphasis on the oxygen delignification stage. In addition the oxygen delignification stage itself is described in more detailed extent in order to understand the mechanisms behind the delignification and fiber damaging effect. The literature available on this subject is unfortunately quite contradictory and implicates a lotof different terms. Only a few studies have been published which help to understand the nature of fiber damages. For that reason the knowledge presented in this work is not only based on previous studies but also on research scientist and mill staff interviews.

In Search of Corporate Renewal: How to Benefit from Corporate Venturing?

Despite the rapid change in today's business environment there are relatively few studies about corporate renewal. This study aims for its part at filling that research gap by studying the concepts of strategy, corporate renewal, innovation and corporate venturing. Its purpose is to enhance our understanding of how established companies operating in dynamic and global environment can benefit from their corporate venturing activities. The theoretical part approaches the research problem in corporate and venture levels. Firstly, it focuses on mapping the determinants of strategy and suggests using industry, location, resources, knowledge, structure and culture, market, technology and business model to assess the environment and using these determinants to optimize speed and magnitude of change.Secondly, it concludes that the choice of innovation strategy is dependent on the type and dimensions of innovation and suggests assessing market, technology, business model as well as novelty and complexity related to each of them for choosing an optimal context for developing innovations further. Thirdly, it directsattention on processes through which corporate renewal takes place. On corporate level these processes are identified as strategy formulation, strategy formation and strategy implementation. On the venture level the renewal processes are identified as learning, leveraging and nesting. The theoretical contribution of this study, the framework of strategic corporate venturing, joins corporate and venture level management issues together and concludes that strategy processes and linking processes are the mechanism through which continuous corporate renewaltakes place. The framework of strategic corporate venturing proposed by this study is a new way to illustrate the role of corporate venturing as a purposefullybuilt, different view of a company's business environment. The empirical part extended the framework by enhancing our understanding of the link between corporate renewal and corporate venturing in its real life environment in three Finnish companies: Metso, Nokia and TeliaSonera. Characterizing companies' environmentwith the determinants of strategy identified in this study provided a structured way to analyze their competitive position and renewal challenges that they arefacing. More importantly the case studies confirmed that a link between corporate renewal and corporate venturing exists and found out that the link is not as straight forward as indicated by the theory. Furthermore, the case studies enhanced the framework by indicating a sequence according to which the processes work. Firstly, the induced strategy processes strategy formulation and strategy implementation set the scene for corporate venturing context and management processes and leave strategy formation for the venture. Only after that can strategies formed by ventures come back to the corporate level - and if found viable in the corporate level be formalized through formulation and implementation. With the help of the framework of strategic corporate venturing the link between corporaterenewal and corporate venturing can be found and managed. The suggested response to the continuous need for change is continuous renewal i.e. institutionalizing corporate renewal in the strategy processes of the company. As far as benefiting from venturing is concerned the answer lies in deliberately managing venturing in a context different to the mainstream businesses and establishing efficientlinking processes to exploit the renewal potential of individual ventures.

Supply chain integration: studies on linking customer responsiveness and operational efficiency in logistics policy planning

Abstract The research problem in the thesis deals with improving the responsiveness and efficiency of logistics service processes between a supplier and its customers. The improvement can be sought by customizing the services and increasing the coordination of activities between the different parties in the supply chain. It is argued that to achieve coordination the parties have to have connections on several levels. In the framework employed in this research, three contexts are conceptualized at which the linkages can be planned: 1) the service policy context, 2) the process coordination context, and 3) the relationship management context. The service policy context consists of the planning methods by which a supplier analyzes its customers' logistics requirements and matches them with its own operational environment and efficiency requirements. The main conclusion related to the service policy context is that it is important to have a balanced selection of both customer-related and supplier-related factors in the analysis. This way, while the operational efficiency is planned a sufficient level of service for the most important customers is assured. This kind of policy planning involves taking multiple variables into the analysis, and there is a need to develop better tools for this purpose. Some new approaches to deal with this are presented in the thesis.The process coordination context and the relationship management context deal with the issues of how the implementation of the planned service policies can be facilitated in an inter-organizational environment. Process coordination includes typically such mechanisms as control rules, standard procedures and programs, but inhighly demanding circumstances more integrative coordination mechanisms may be necessary. In the thesis the coordination problems in third-party logistics relationship are used as an example of such an environment. Relationship management deals with issues of how separate companies organize their relationships to improve the coordination of their common processes. The main implication related to logistics planning is that by integrating further at the relationship level, companies can facilitate the use of the most efficient coordination mechanisms and thereby improve the implementation of the selected logistics service policies. In the thesis, a case of a logistics outsourcing relationship is used to demonstrate the need to address the relationship issues between the service provider andthe service buyer before the outsourcing can be done.The dissertation consists of eight research articles and a summarizing report. The principal emphasis in the articles is on the service policy planning context, which is the main theme of six articles. Coordination and relationship issues are specifically addressed in two of the papers.

"Sanat ovat käsiä, joilla voi koskettaa toista" : John Shotterin haastattelu

Haastattelijan suomennos: Onnismaa, J. 2005. "You can touch other people with your words". Interview with John Shotter. Lifelong learning in Europe LLinE 10 (4): 242-247

Handover aspects in Unlicensed Mobile Access Technology

Fixed Mobile Convergence is the recent buzz in the field of telecommunication technology. Unlicensed Mobile Access (UMA) technology is a realistic implementation of Fixed Mobile Convergence. UMA involves communication between different types of networks. Handover is a very important issue in UMA. The study is an analysis of theoretical handover mechanism and practical test results. It includes a new proposal for handover performance test in UMA. It also provides an overview of basic handover operation on different scenarios in UMA. The practical test involves an experiment on handover performance test using network analyzers. The new proposal provides a different approach for an experimental setting on handover performance test without using network analyzers. The approach is not be implemented because of some technical problem in a network equipment in UMA. The analysis of the test results reveals that time of handover between UMA and Global System for Mobile Communication (GSM) network is similar to time of handover between inter base station controller (BSC) handover in GSM networks. The new approach is simple and provides measurement at the end point communicating entities. The study gives a general understanding of handover operation, an analysis of handover performance in UMA and specifically provides a new approach useful for further study of handover in different real world environments and scenarios.

The Innovation Process – Aiming towards Innovativeness in a Construction Company

The bachelor’s thesis concentrates on the innovativeness in the construction industry. The purpose of the thesis is to define the innovation as a concept reflected on a context of the construction industry. The second objective is to examine how the construction companies could foster and increase the innovativeness. The third objective was to find out tools, methods and phases of the front-end of the innovation process. The construction industry is often considered as a traditional and an old-fashioned manufacturing industry. The innovation or the innovativeness rarely linked to the construction industry. Productivity is a common problem in the construction industry. The construction industry needs to increase the productivity to compete in a globalized world. The productivity can be increased by the innovation. The thesis based on a literature review. The findings from the literature include a description of the innovation as a concept, the innovative culture and the innovation process as a context of the construction industry. The phases of the front-end of the innovation process were explained. Customers centered approach was taken into account in the innovation process. The required tools and methods for managing the front-end of the innovation process were illustrated. The thesis ensures the importance of the innovation facing challenges of the construction industry. Managing the front-end of the innovation is the most important aspect to stand out from the less innovative companies. To take a full advantage of the innovation companies cannot fear of changes. The innovation process requires a full support of the top management of the company. Taking into consideration a theoretical aspect of the thesis a further research is required to respond practical needs of the company. Tools and methods should be considered according the company’s needs and activities. Company’s existing state and culture should be examined before implementing the front-end of the innovation process to ensure the functionality.

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.

Essays on Business and Leadership Ethics

As this is a dissertation, an academic thesis, it is important to define the objectives of my research, even if ex post facto, explicitly: - To define, develop and study the concept of business and leadership ethics. - To empirically study the phenomena associated with business and leadership from an ethical perspective. - To create a new framework for the development of responsible business. - To create an “acid test” for my body of works, i.e. a test and an evaluation on how well my research and ideas hold up under academic philosophical reflection. The utilitarian reasoning had the most support when the actors justified their actions regarding economic benefit. (=instrumental good). Duty and benefit were often mixed up in people’s speech. Their meaning contents were blurred and the argumentation lines created by the actors were broken. This can be interpreted in a way that supports Frankena’s mixed deontological philosophy as a frame of reference. Deontologica reasoning was used e.g. in describing the personnel management processes of a company. Virtue ethics is a favourable starting point for studying management and leadership ethics. All the actors studied could name virtues for their operations, towards which to aspire to. They also named professional practices already in use that they considered to be virtuous. Finally, I wish to state that normative ethics is an important branch of philosophical ethics, if also very important in applied ethics especially. From the normative standpoint, the results of this dissertation want to lead nations, communities and individuals towards the virtues of democratic leadership and sustainable economic development.