The forced adoption of a fast-track appraisal process for a breast cancer treatment in UK

Trastuzumab (Herceptin ®, Roche) is approved in UK for the treatment of the metastatic breast cancer since 2001. As of 2005, concomitantly with the publication of 3 studies that showed it produces a 50% reduction of the recurrence rates of breast cancer, trastuzumab started to be prescribed in the earlt adjuvant treatrnent of this disease. Und June 2006, trastuzumab did not have both: 1) regulatory approval and 2) NICE [National Institute for Health and Clinical Excellence] recommendation for the use in early stages of breast cancer. During the period until June 2006, the trastuzumab use in those patients was not reimbursed and because the cost of trastuzumab is equal with the yearly UK average income, most of patients could not self fund their treatrnent. Before the publication of the final NICE guidance, the new data of trastuzumab in early breast cancer raised enormous patient and professional interest and expectations. A great volume of public and professional pressure was generated to transcend a system by which Primary Care Trusts can reimburse a treatment only after a formal guidance was issued. This paper draw on a case study depicting and analyzing the process by which regulatory approval and NICE recommendations were achieved in a record time and how trastuzumab became a standard treatment on early adjuvant breast cancer. According to the data we gathered in this work we were witnessing one of the fastest processes of adoption of a health care technology since the creation of NICE, in 1999. This study addresses the following research question: How and why does the adoption pattern of trastuzumab differ from the rational decision-making model of the reimbursement process in UK? [Author, p. 4]

An integrated model of adoption and development of e-commerce in companies

Since the mid-1990s researchers have sought to understand why some firms embark on e-commerceoperations on the Internet while others prefer to wait and see how events unfold. We still have todetermine which variables contribute to explaining the extent to which firms use e-commerce, giventhat to date the literature has not yet offered conclusive evidence on this question. The current workaims to provide an integrated vision of the set of factors influencing the e-commerce adoptionprocess. We use a sample of 2,038 firms of all types that trade their products either with otherorganizations or with end-consumers.

Robotics adoption among the elderly

Editorial material

Tiedon tuottaminen ja vaikuttaminen: prosessi ja liitynnät tietolähteisiin

Diplomityön tavoitteena on helpottaa Energiamarkkinaviraston tietomassojen käsittelyä ja tehostaa organisaatiotiedon hallintaa. Keskeisin tavoite on määritellä ja kuvata viraston tiedon tuottamis- ja vaikuttamisprosessi sekä sen liitynnät sisäisiin ja ulkoisiin tietolähteisiin. Työssä perehdytään organisaatiotiedon nykytilanteeseen, tiedon tuottamiseen ja vaikuttamiseen sekä ehdotetaan useita keinoja olemassa olevan tietomassan tehokkaampaan hyödyntämiseen. Työssä analysoidaan millaista tietoa virastossa tarvitaan, missä tieto on saatavilla ajantasaisena sekä luotettavana ja mihin hankittua tietoa loppujen lopuksi käytetään. Nykytilanteen selvittämisen lisäksi työssa ehdotetaan keinoja, joiden avulla organisaatiotieto saadaan nostettua nykyiseltä, pääosin operatiiviselta tasolta vähintään täysin taktiselle tai jopa osin strategiselle tasolle. Lisaksi työssä selvitetään kuinka virasto pystyy hankkimaan tietoa uudenlaiseen tietotarpeeseen. Työn keskeisimmät tulokset ovat diplomityössä esille nostetut kehityskohteet liittyen tietolähteiden hyödyntämiseen, internetsivuston uudistamiseen, uusien analyysien tuottamiseen, tärkeiden ohjeistusten tekemiseen ja prosessien suunnitteluun sekä automatisointiin. Näihin voidaan puuttua prosessikeskeisen ajattelutavan ja proaktiivisuuden lisäämisellä.

Business opportunities in power sector of Ukraine : focus small-scale hydro and wind power sectors

In the last few years, the Ukrainian investment market has constantly shown strong performance and significant growth. This is primarily due to the investment attractiveness of Ukraine. From the perspective of investments in energy sector, Ukraine can be described as a country providing significant number of opportunities to multiply invested funds. But there are numbers of risks which hamper large investments. The work objective was to discover opportunities in small-scale hydropower and wind power sectors of Ukraine and more importantly to prove economic expediency of such investments. Thesis covers major of issues, concerning entering the Ukrainian power market as a foreign investor. It provides basic information about the structure of power market, the state of renewables sector in Ukraine, development of power sector in the regions, functioning of Wholesale Electricity Market, formation of electricity prices, possibilities for implementing joint Implementation mechanism, while the most attention, nevertheless, is concentrated on the opportunities in small-scale hydro and wind power sectors. Theoretical part of the study disclosed that Crimea peninsula has perfect wind conditions and could be a prospective area for wind project development. Investment analysis revealed that project profits will be excellent if green tariff for renewable energy is adopted. By the moment uncertainties about green law adoption bring additional risk to the projects and complicate any investment decision.

Environmental policy instruments concerning industrial end-use energy efficiency

Energy efficiency and saving energy are the main question marks when thinking of reducing carbon dioxide emissions or cutting costs. The objective of thesis is to evaluate policy instruments concerning end-use energy efficiency of heavy industry in European Union. These policy instruments may be divided in various ways, but in this thesis the division is to administrative, financial, informative and voluntary instruments. Administrative instruments introduced in this thesis are Directive on Integrated Pollution Prevention and Control, Directive on Energy End-use Efficiency and Energy Services, and Climate and Energy Package. Financial means include energy and emission taxation, EU Emission Trading Scheme and diverse support systems. Informative instruments consist of horizontal BAT Reference Document for Energy Efficiency, as well as substantial EU documents including Green Paper on Energy Efficiency, Action Plan for Energy Efficiency and An Energy Policy for Europe. And finally, voluntary instruments include environmental managements systems like ISO 14001 and EMAS, energy auditing and benchmarking. The efficiency of different policy instruments vary quite a lot. Informative instruments lack the commitment from industry and are thus almost ineffective, contrary to EU Emission Trading Scheme, which is said to be the solution to climate problems. The efficiency of administrative means can be placed between those mentioned and voluntary instruments are still quite fresh to be examined fruitfully. However, each instrument has their potential and challenges. Cases from corporate world strengthen the results from theoretical part. Cases were written mainly on the basis of interviews. The interviewees praised the energy efficiency contract of Finnish industry, but the EU ETS takes the leading role of policy instruments. However, for industry the reductions do not come easily.

MENTAL FILES AND METAFICTIVE UTTERANCES

ABSTRACT Metafictive utterances raise a kind of intuitions (intuitions of truthfulness) that pose a problem for a view that combines a referentialist approach to proper names with an antirealist stance on fictional characters. In this article I attempt to provide a solution to this problem within the framework of mental files. According to my position, metafictive utterances literally express an incomplete proposition while pragmatically conveying a complete one, which accounts for the intuitions of truthfulness. The proposition pragmatically conveyed is ‘metarepresentational', I'll argue, in the sense that it is about a mental representation or mental file.

Analysis of companies' software as a service adoption intention factors

The goal of this study is to develop managerial recommendations for international vendors and system integrators, which offer Software as a Service for enterprise information systems on the Russian market. Those recommendations can be used to develop marketing, sales, new product and service level agreement strategies. For those reasons factors affecting SaaS adoption were determined and their influence on intention to adoption was examined.

Towards adoption of eLearning technologies at Lappeenranta University of Technology: Understanding Teachers‟ Adoption of Blackboard Learning System

The electronic learning has become crucial in higher education with increased usage of learning management systems as a key source of integration on distance learning. The objective of this study is to understand how university teachers are influenced to use and adopt web-based learning management systems. Blackboard, as one of the systems used internationally by various universities is applied as a case. Semi-structured interviews were made with professors and lecturers who are using Blackboard at Lappeenranta University of Technology. The data collected were categorized under constructs adapted from Unified Theory of Acceptance and Use of Technology (UTAUT) and interpretation and discussion were based on reviewed literature. The findings suggest that adoption of learning management systems by LUT teachers is highly influenced by perceived usefulness, facilitating conditions and gained experience. The findings also suggest that easiness of using the system and social influence appear as medium influence of adoption for teachers at LUT.

Environmental inFluences on the Adoption of Open Innovation: Analysis of Structural, Institutional and Cultural Impacts

The concept of open innovation has recently gained widespread attention, and is particularly relevant now as many firms endeavouring to implement open innovation, face different sets of challenges associated with managing it. Prior research on open innovation has focused on the internal processes dealing with open innovation implementation and the organizational changes, already taking place or yet required in companies order to succeed in the global open innovation market. Despite the intensive research on open innovation, the question of what influences its adoption by companies in different contexts has not received much attention in studies. To fill this gap, this thesis contribute to the discussion on open innovation influencing factors by bringing in the perspective of environmental impacts, i.e. gathering data on possible sources of external influences, classifying them and testing their systemic impact through conceptual system dynamics simulation model. The insights from data collection and conceptualization in modelling are used to answer the question of how the external environment affects the adoption of open innovation. The thesis research is presented through five research papers reflecting the method triangulation based study (conducted at initial stage as case study, later as quantitative analysis and finally as system dynamics simulation). This multitude of methods was used to collect the possible external influence factors and to assess their impact (on positive/negative scale rather than numerical). The results obtained throughout the thesis research bring valuable insights into understanding of open innovation influencing factors inside a firm’s operating environment, point out the balance required in the system for successful open innovation performance and discover the existence of tipping point of open innovation success when driven by market dynamics and structures. The practical implications on how firms and policy-makers can leverage environment for their potential benefits are offered in the conclusions.

Adoption of information technology based patient education in psychiatric nursing

The overall goal of the study was to describe adoption of information technology (IT)-based patient education (PE) developed for patients and nurses use in psychiatric nursing. The data were collected in three phases during the period 2000-2006 in a variety of psychiatric settings in Finland. Firstly, the development process of IT-based PE for patients with schizophrenia spectrum psychosis was described. Secondly, nurses’ adoption of IT-based PE and the variables explaining adoption were demonstrated. Moreover, use of daily IT-based PE in clinical practice and factors associated with use were identified and described. And thirdly, nurses’ experiences of the IT-based PE after one year clinical use were evaluated. IT-based PE program was developed in several stages based on users’ needs and it included information and multimedia applications. Altogether, almost 500 IT-based PE sessions were carried out by the nurses on the study wards and revealed nurses’ activity in educating patients using IT to vary and depend on the hospital in which they worked. Almost 80% of all the possible IT-based PE sessions involved 93 patients and 83 nurses. Less than 2% of the IT-based PE sessions were interrupted and less than 10% suffered disturbances due to the patients or external causes. Moreover, the patients whose education took more days had poorer mental status than those whose education was carried out over a shorter period. After a year’s experience, advantages and disadvantages were described by the nurses for both patients and nurses of the IT-based PE. IT-based PE can be used even on closed acute psychiatric wards with patients with serious mental health disorders. However, technology adoption requires time, and therefore, it must fit in with clinical practice. Collaboration between users and developers is needed when developing user-centered methods in the area of mental health services. Moreover, it is important to understand factors that affect IT adoption in healthcare settings. IT-based PE is one option in interactive and co-operative health care practice between patients and nurses. Therefore the staff should begin to refer patients to established, credible and well-maintained Internet sites that provide information on common psychological problems. Even if every nurse should be trained and engaged to carry out IT-based PE, by targeting the training especially for the most active nurses aids them to support the less active ones. Adoption should also be understood from a perspective that includes aspects related to the context where it is implemented and examine how and in what circumstances it works.