Acceptance and Use of Information Technology among Nurses in Psychiatric Hospitals

Hoitajien informaatioteknologian hyväksyntä ja käyttö psykiatrisissa sairaaloissa Informaatioteknologian (IT) käyttö ei ole ollut kovin merkittävässä roolissa psykiatrisessa hoitotyössä, vaikka IT sovellusten on todettu vaikuttaneen radikaalisti terveydenhuollon palveluihin ja hoitohenkilökunnan työprosesseihin viime vuosina. Tämän tutkimuksen tavoitteena on kuvata psykiatrisessa hoitotyössä toimivan hoitohenkilökunnan informaatioteknologian hyväksyntää ja käyttöä ja luoda suositus, jonka avulla on mahdollista tukea näitä asioita psykiatrisissa sairaaloissa. Tutkimus koostuu viidestä osatutkimuksesta, joissa on hyödynnetty sekä tilastollisia että laadullisia tutkimusmetodeja. Tutkimusaineistot on kerätty yhdeksän akuuttipsykiatrian osaston hoitohenkilökunnan keskuudessa vuosien 2003-2006 aikana. Technology Acceptance Model (TAM) –teoriaa on hyödynnetty jäsentämään tutkimusprosessia sekä syventämään ymmärrystä saaduista tutkimustuloksista. Tutkimus osoitti kahdeksan keskeistä tekijää, jotka saattavat tukea psykiatrisessa sairaalassa toimivien hoitajien tietoteknologiasovellusten hyväksyntää ja hyödyntämistä, kun nämä tekijät otetaan huomioon uusia sovelluksia käyttöönotettaessa. Tekijät jakautuivat kahteen ryhmään; ulkoiset tekijät (resurssien suuntaaminen, yhteistyö, tietokonetaidot, IT koulutus, sovelluksen käyttöön liittyvä harjoittelu, potilas-hoitaja suhde), sekä käytön helppous ja sovelluksen käytettävyys (käytön ohjeistus, käytettävyyden varmistaminen). TAM teoria todettiin käyttökelpoiseksi tulosten tulkinnassa. Kehitetty suositus sisältää ne toimenpiteet, joiden avulla on mahdollista tukea sekä organisaation johdon että hoitohenkilökunnan sitoutumista ja tätä kautta varmistaa uuden sovelluksen hyväksyntä ja käyttö hoitotyössä. Suositusta on mahdollista hyödyntää käytännössä kun uusia tietojärjestelmiä implementoidaan käyttöön psykiatrisissa sairaaloissa.

Nurses’ Acceptance of an Internet-Based Support System in The Care of Adolescents with Depression

The overall goal of the study was to describe nurses’ acceptance of an Internet-based support system in the care of adolescents with depression. The data were collected in four phases during the period 2006 – 2010 from nurses working in adolescent psychiatric outpatient clinics and from professionals working with adolescents in basic public services. In the first phase, the nurses’ anticipated perceptions of the usefulness of the Internet-based support system before its implementation was explored. In the second phase, the nurses’ perceived ease of computer and Internet use and attitudes toward it were explored. In the third phase, the features of the support system and its implementation process were described. In the fourth phase, the nurses’ experiences of behavioural intention and actual system use of the Internet-based support were described in psychiatric out-patient care after one year use. The Technology Acceptance Model (TAM) was used to structure the various research phases. Several benefits were identified from the nurses’ perspective in using the Internet-based support system in the care of adolescents with depression. The nurses’ technology skills were good and their attitudes towards computer use were positive. The support system was developed in various phases to meet the adolescents’ needs. Before the implementation of the information technology (IT)-based support system, it is important to pay attention to the nurses’ IT-training, technology support, resources, and safety as well as ethical issues related to the support system. After one year of using the system, the nurses perceived the Internet-based support system to be useful in the care of adolescents with depression. The adolescents’ independent work with the support system at home and the program’s systematic character were experienced as conducive from the point of view of the treatment. However, the Internet-based support system was integrated only partly into the nurseadolescent interaction even though the nurses’ perceptions of it were positive. The use of the IT-based system as part of the adolescents’ depression care was seen positively and its benefits were recognized. This serves as a good basis for future IT-based techniques. Successful implementations of IT-based support systems need a systematic implementation plan and commitment from the part of the organization and its managers. Supporting and evaluating the implementation of an IT-based system should pay attention to changing the nurses’ work styles. Health care organizations should be offered more flexible opportunities to utilize IT-based systems in direct patient care in the future.

Careers of Managers, Comparison between ICT and Paper Business Sectors

The purpose of this study is to increase understanding of how the managers build their early career in information and communication technology industry (ICT business sector) and pulp- and paper industry (paper business sector). The focus of the study is to explore the importance differing a business sectors have in influencing managerial careers. Business sectors can affect careers in several ways.Sectors have different history and traditions. Also the age structure of ICT personnel differs from the age structure of personnel in the paper industry. Managers in the ICT and paper sector are technically educated but in different disciplines. Differences exist also in ways of recruiting and developing commitment inpersonnel. The target group of this research, middle management engineering personnel, work in Finnish ICT and paper companies. Research data were gathered in April-December 2002 in South-Karelia by interviewing 30 managers and six directors working in three Finnish ICT companies and in three paper companies. The research issue is approached on two levels: the individual level and the organizational level. The managers related their career stories in focused interviews. Directors, representing the organizations, described the generalities of the business sector and gave background information on company policies, human relationshippractices, as well as career and human resource development. Results of the study contribute to research discussions of career, life-span reasoning, socialization and commitment. Career is conceived as a series of positions including everykind of hierarchical mobility and all kinds of positions in work. A manager's career develops in interaction with the organization and it can be seen as involving a socializing process in an organization as a consequence of experiences andchanges in positions. This research contributes to the understanding of the nature of career in the context of two business sectors. Universal career theories,for the most part, do not perceive the importance of business sector in determining career experience. This study concentrates on describing and understanding early careers in two different business areas, elements committing managers to particular business sectors and the actions of companies in that particular sector. While career research began in the middle of 1950s, the theoretical basis of career research seems to be quite fragmented still. However, a dichotomy is consistently presented between traditional, hierarchical career research and boundaryless career thinking. In this research we examine how these old and new career concepts are evidence in the ICT and paper sectors. Careers are changing from formal, hierarchy-based structures to more fluid arrangements. The new boundaryless career concept captures territory from old career thinking. Mobility between employers, networks, and changing hierarchical structures in organizations, as well as personal and family reasons are theorized to bring changes to careers patterns in the future. However, the pace of this change in careers will vary between the ICT and paper business sectors. Findings of this research indicate that business sector has an effect on how managerial careers develop. The environment where career is developed differs between ICT and paper sectors. Careers begin differently in the two environments and the speed of career progression is distinct. ICT careers are built within the business sector whereas paper careers are made inside one company. Also recruiting and socialization practices differ from one sector to the other.

Innate and Adaptive Immunity in Orolabial Herpes Simplex

Oral mucosa is a frequent site of primary herpes simplex virus type 1 (HSV-1) infection, whereas intraoral recurrent disease is very rare. Instead, reactivation from latency predominantly results in asymptomatic HSV shedding to saliva or recurrent labial herpes (RLH) with highly individual frequency. The current study aimed to elucidate the role of human oral innate and acquired immune mechanisms in modulation of HSV infection in orolabial region. Saliva was found to neutralize HSV-1, and to protect cells from infection independently of salivary antibodies. Neutralization capacity was higher in saliva from asymptomatic HSV-seropositive individuals compared to subjects with history of RLH or seronegative controls. Neutralization was at least partially associated with salivary lactoferrin content. Further, lactoferrin and peroxidase-generated hypothiocyanite were found to either neutralize HSV-1 or interfere with HSV-1 replication, whereas lysozyme displayed no anti-HSV-1 activity. Lactoferrin was also shown to modulate HSV-1 infection by inhibiting keratinocyte proliferation. RLH susceptibility was further found to be associated with Th2 biased cytokine responses against HSV, and a higher level of anti- HSV-IgG with Th2 polarization, indicating lack of efficiency of humoral response in the control of HSV disease. In a three-dimensional cell culture, keratinocytes were found to support both lytic and nonproductive infection, suggesting HSV persistence in epithelial cells, and further emphasizing the importance of peripheral immune control of HSV. These results suggest that certain innate salivary antimicrobial compounds and Th1 type cellular responses are critically important in protecting the host against HSV disease, implying possible applications in drug, vaccine and gene therapy design.

Effects of business-to-business customer orientation, satisfaction and retention on firm profitability

The objective of this master’s thesis was to examine the effect of customer orientation on customer satisfaction and how customer satisfaction and customer retention contribute to firm profitability. Beside customer orientation, also other antecedents of customer satisfaction, i.e. service quality, flexibility, trust and commitment, were investigated as control variables. Literature review revealed several research gaps concerning research of the key concepts. These research calls were also answered. The empirical study focused on one case company, a telecommunication expert. The data for the empirical part was collected with web-based questionnaire from case company’s business customers in January-February 2008. Sample (N=95) produced 59 answers, thus the response rate of the survey was 62,1%. The data was analyzed by using statistical analysis program, SPSS. As a conclusion, the results indicate that customer orientation do not affect customer satisfaction directly, but through service quality, flexibility and trust. Moreover, customer satisfaction has positive impacts on commitment and intentions to stay as a customer in the future, but not on profitability. In the present study, only past purchase behavior, measured with customer database measure, is positively related to firm profitability.

Economical and operational analysis of outsourced warehouse function

The target of the thesis was to find out has the decision to outsource part of Filtronic LK warehouse function been profitable. Furthermore, another thesis target was to demonstrate current logistics processes between TPLP and company and find out the targets for developing these processes. The decision to outsource part of logistical funtions have been profitable during the first business year. Partnership includes always business risks. Risk increases high asset specific investments. In the other hand investment to partnership increases mutual trust and commitment between parties. By developing partnership risks and opportunitic behaviour can be decreased. The potential of managing material and data flows between logistic service provider and company observed. By analyzing inventory effiency were highlighted the need for decreasing the capital invested to inventories. The recommendations for managing outsourced logistical funtions were established such as improving partnership, process development, performance measurement and invoice checking.

Making Sense of Shared Leadership. A case study of leadership processes and practices without formal leadership structure in the team context

Leadership is essential for the effectiveness of the teams and organizations they are part of. The challenges facing organizations today require an exhaustive review of the strategic role of leadership. In this context, it is necessary to explore new types of leadership capable of providing an effective response to new needs. The presentday situations, characterized by complexity and ambiguity, make it difficult for an external leader to perform all leadership functions successfully. Likewise, knowledge-based work requires providing professional groups with sufficient autonomy to perform leadership functions. This study focuses on shared leadership in the team context. Shared leadership is seen as an emergent team property resulting from the distribution of leadership influence across multiple team members. Shared leadership entails sharing power and influence broadly among the team members rather than centralizing it in the hands of a single individual who acts in the clear role of a leader. By identifying the team itself as a key source of influence, this study points to the relational nature of leadership as a social construct where leadership is seen as social process of relating processes that are co-constructed by several team members. Based on recent theoretical developments concerned with relational, practice-based and constructionist approaches to the study of leadership processes, this thesis proposes the study of leadership interactions, working processes and practices to focus on the construction of direction, alignment and commitment. During the research process, critical events, activities, working processes and practices of a case team have been examined and analyzed with the grounded theory –approach in the terms of shared leadership. There are a variety of components to this complex process and a multitude of factors that may influence the development of shared leadership. The study suggests that the development process of shared leadership is a common sense -making process and consists of four overlapping dimensions (individual, social, structural, and developmental) to work with as a team. For shared leadership to emerge, the members of the team must offer leadership services, and the team as a whole must be willing to rely on leadership by multiple team members. For these individual and collective behaviors to occur, the team members must believe that offering influence to and accepting it from fellow team members are welcome and constructive actions. Leadership emerges when people with differing world views use dialogue and collaborative learning to create spaces where a shared common purpose can be achieved while a diversity of perspectives is preserved and valued. This study also suggests that this process can be supported by different kinds of meaning-making and process tools. Leadership, then, does not reside in a person or in a role, but in the social system. The built framework integrates the different dimensions of shared leadership and describes their relationships. This way, the findings of this study can be seen as a contribution to the understanding of what constitutes essential aspects of shared leadership in the team context that can be of theoretical value in terms of advancing the adoption and development process of shared leadership. In the real world, teams and organizations can create conditions to foster and facilitate the process. We should encourage leaders and team members to approach leadership as a collective effort that the team can be prepared for, so that the response is rapid and efficient.

Proactive and Preventive Student Welfare Activities in Finnish Preschool and Elementary School: Handling of Transition to Formal Schooling and a National Anti-Bullying Program as Examples

Prerequisites and effects of proactive and preventive psycho-social student welfare activities in Finnish preschool and elementary school were of interest in the present thesis. So far, Finnish student welfare work has mainly focused on interventions and individuals, and the voluminous possibilities to enhance well-being of all students as a part of everyday school work have not been fully exploited. Consequently, in this thesis three goals were set: (1) To present concrete examples of proactive and preventive psycho-social student welfare activities in Finnish basic education; (2) To investigate measurable positive effects of proactive and preventive activities; and (3) To investigate implementation of proactive and preventive activities in ecological contexts. Two prominent phenomena in preschool and elementary school years—transition to formal schooling and school bullying—were chosen as examples of critical situations that are appropriate targets for proactive and preventive psycho-social student welfare activities. Until lately, the procedures concerning both school transitions and school bullying have been rather problem-focused and reactive in nature. Theoretically, we lean on the bioecological model of development by Bronfenbrenner and Morris with concentric micro-, meso-, exo- and macrosystems. Data were drawn from two large-scale research projects, the longitudinal First Steps Study: Interactive Learning in the Child–Parent– Teacher Triangle, and the Evaluation Study of the National Antibullying Program KiVa. In Study I, we found that the academic skills of children from preschool–elementary school pairs that implemented several supportive activities during the preschool year developed more quickly from preschool to Grade 1 compared with the skills of children from pairs that used fewer practices. In Study II, we focused on possible effects of proactive and preventive actions on teachers and found that participation in the KiVa antibullying program influenced teachers‘ self-evaluated competence to tackle bullying. In Studies III and IV, we investigated factors that affect implementation rate of these proactive and preventive actions. In Study III, we found that principal‘s commitment and support for antibullying work has a clear-cut positive effect on implementation adherence of student lessons of the KiVa antibullying program. The more teachers experience support for and commitment to anti-bullying work from their principal, the more they report having covered KiVa student lessons and topics. In Study IV, we wanted to find out why some schools implement several useful and inexpensive transition practices, whereas other schools use only a few of them. We were interested in broadening the scope and looking at local-level (exosystem) qualities, and, in fact, the local-level activities and guidelines, along with teacherreported importance of the transition practices, were the only factors significantly associated with the implementation rate of transition practices between elementary schools and partner preschools. Teacher- and school-level factors available in this study turned out to be mostly not significant. To summarize, the results confirm that school-based promotion and prevention activities may have beneficial effects not only on students but also on teachers. Second, various top-down processes, such as engagement at the level of elementary school principals or local administration may enhance implementation of these beneficial activities. The main message is that when aiming to support the lives of children the primary focus should be on adults. In future, promotion of psychosocial well-being and the intrinsic value of inter- and intrapersonal skills need to be strengthened in the Finnish educational systems. Future research efforts in student welfare and school psychology, as well as focused training for psychologists in educational contexts, should be encouraged in the departments of psychology and education in Finnish universities. Moreover, a specific research centre for school health and well-being should be established.

The Impact of Service Quality and Relationship Quality on Customer Loyalty in Business-to-Business Context

The main objective of this Master’s Thesis was to examine the interrelations of service quality and relationship quality (customer satisfaction, trust and commitment), and find out are they antecedents for customer loyalty in business-to-business context. Literature review revealed some research gaps concerning these focal concepts, which should be studied more closely. The theoretical basis for this research was collected for evaluating a strategic increase of customer’s perceptions of service quality and relationship quality as well as customer loyalty in business-to-business environment, and it was tested empirically in a sample of 164 corporate customers, who responded to the Internet-based survey. The measures, used in the survey, were first assessed by using confirmatory factor analysis (CFA), and then the hypothesized relationships were further verified using structural equation modeling (SEM) in LISREL 8.80. There was found support for a half of the hypothesized construct relations. The results of the research confirm the direct influence of trust and commitment on customer loyalty. Also, service quality turned out to have an indirect impact on customer loyalty through trust. No support, however, was offered for the proposed impact of customer satisfaction on loyalty in this case. The research provides managerially relevant and actionable results that may help service providers execute more specific customer relationship quality strategies that lead to higher customer loyalty.

The key practices of customer portfolio management (CPM) process in the medical and healthcare B2B industry

The goal of this study is to deepen the understanding of the customer portfolio management process. There are many models for the process, and they are not necessarily exclusive of each other. Consequently, the inclusion of many models might even prove out to be beneficial. Other theoretical framework include the current economical situation and its propose on customer portfolio management. With an understanding of the theoretical models as a background, the empirical part of this study compares Finnish multinational medical and healthcare technology companies’ customer portfolio management practices. The empirical research was carried out with theme interviews held with 11 sales and marketing managers or directors from four different companies. The goal was to discover the most essential practices of the process steps in the companies. The result of this study is that there is a lack of systematic customer portfolio management, but most companies are aiming to improve this in the near future. The most essential practices are analysis of sales, communication level, learning, and commitment to strategy of the focal company. Special characteristics of this industry include large business networks that include customers, professional end-users, institutions, universities, researchers, and key opinion leaders. The management and analysis of this comprehensive network has been seen to be extremely important for this industry.

Social networks and networking facilitating internationalization: Experiences of two Finnish fashion companies

Background: Fashion is a dynamic and creative industry where larger retailers are enjoying international success. Small businesses however are struggling in the face of international expansion, as they lack the necessary resources and managerial know-how. The Finnish fashion industry has neither been able to develop the industry environment to support small and micro firms nor has Finland relevant finance or public domains, such as, seen in other Nordic countries. Networking has been recognized to facilitate organizational growth and international expansion in industries such as manufacturing and high technology. It has enabled smaller companies to gain resources, knowledge and experiences otherwise unattainable. Objective: The purpose of this study was to explore how networking has been utilized in the Finnish fashion industry. Particularly social relationships and networks are examined, as they emphasize the importance of individuals. Exploration on the past actions should also provide insight how networks and networking could be utilized and developed in the future. Main findings: It was discovered that the Finnish fashion industry (social) network is rather dense. This was mainly due to the small size of the Finnish market. In the early years of the establishment of the company, close contacts seemed to be utilized. As a company expands and extends its business, the relationships tended to move towards more utilitarian in nature. However, in some cases, the long term relationships had also affectionate features, such as trust and commitment. International networking was found to have positive impact on business opportunities. Participation to events, such as trade shows, was perceived as one of the best ways to meet new international contacts and to develop ones network. Active networking in the Finnish market, however, created both domestic and international opportunities. Furthermore, cooperation and open communication were discovered to facilitate innovation and projects. The public sector seemed to lack the interest in supporting the fashion industry according to the interviewees. The major issues for the fashion industry still concerned, among others, funding, administrative guidance and public support for developing the industry as a whole.

Best practices of international double degree programmes. Case of Russian and European universities

The purpose of the Master’s thesis research is to study and disseminate the best practices of international double Master’s degree programmes organization, implementation and development. The given research is focused on two main areas: motivation of higher education institutions to start double degree programmes and best practices of double degree programme design and implementation from the perspective of building joint curriculum and organizing balanced mobility and development of existing programmes in terms of increasing their quality and attractiveness. This is a case study of the double degree programmes between Russian and European universities. The study findings reveal good developments in the field of double degree cooperation between Russian and European universities and a high motivation from both parties. The research depicts different models of building a joint curriculum and organizing academic mobility. The following areas could be outlined as development points for double degree programmes: - Personal interest and commitment of organizers of double degree programmes; - Comprehensive agreement between partners on different aspects and practicalities of the double degree programme implementation; - Promotion towards more balanced student participation and two-way mobility; - Foreign language skills improvement for students and university staff; - Joint strategy and actions in marketing and quality assurance; - Involvement of international companies; - Wider usage of e-learning technology.

Improving reporting and internal control with process thinking - case study in a multinational corporation

The aim of this Master’s Thesis is to find applicable methods from process management literature for improving reporting and internal control in a multinational corporation. The method of analysis is qualitative and the research is conducted as a case study. Empirical data collection is carried out through interviews and participating observation. The theoretical framework is built around reporting and guidance between parent company and subsidiary, searching for means to improve them from process thinking and applicable frameworks. In the thesis, the process of intercompany reporting in the case company is modelled, and its weak points, risks, and development targets are identified. The framework of critical success factors in process improvement is utilized in assessing the development targets. Also internal control is analyzed with the tools of process thinking. As a result of this thesis, suggestions for actions improving the reporting process and internal control are made to the case company, the most essential of which are ensuring top management’s awareness and commitment to improvement, creating guidelines and tools for internal control and creating and implementing improved intercompany reporting process.

Commitment in Finnish–Japanese strategic alliances

Finnish companies have usually formed a strategic alliance as entry mode when entering the Japanese market. However, these strategic alliances have not been studied in a general level and it remains unknown, what kind cooperation the Finnish companies are operating with their Japanese partners. Especially Finnish companies that aims to penetrate the Japanese market are eager to know more about this. The recent studies on topic have focused on a single industry or company and that is why more general level study was needed. The purpose of this study is to analyze types of Finnish–Japanese strategic alliances from the Finnish point of view. The analysis is conducted by answering the questions what strategic alliance types appear in the strategic alliances between Japanese and Finnish companies, and how commitment affects strategic alliance type. This study also examines how committed Finnish–Japanese strategic alliances are. In this study multiple case study was selected as research method. The data is collected by interviewing six representative of Finnish companies in Japan individually. Multiple case study was chosen for this study, because this study is interested in the topic in general level and this research method is suitable for this kind of research. From the interviews common attributes were pointed out and from them the big picture of the topic was created. Types of strategic alliances were determined by using previous literature on that topic. Two different types of strategic alliance were discovered: supplier alliance which is the most common one and learning alliance. The commitment of strategic alliance was measured visually by utilizing a figure that was modified for this study.The figure is originally based on earlier studies on strategic alliance types and their connection to ownership and commitment. By utilizing the figure it was noticed that commitment affects strategic alliance types: the more there is commitment involved, the more there is cooperation. Finnish–Japanese strategic alliances are not very committed despite they have existed for a long time. However, there is potential to be more committed. That is why Finnish companies should increase the commitment and attract the partners to develop the strategic alliances, because it would possible increase competitive advantage. This would be beneficial to all members within the strategic alliance.