The principle of autonomy in Brazil: one needs to discuss it ...

The principle of patient autonomy is a cornerstone of bioethics. According to this concept, patients should be given the power to make decisions related to their treatment. It is an important component of modern medical ethics, which has received much interest in current literature. However, the rate of participation of patients and their willingness to participate are variable according to the cultural, social and family environments in which they are inserted. The aim of this paper is to promote a brief descriptive review on autonomy, the preferences of patients and the use of informed consent as an instrument for the exercise of autonomy in literature, and to stress the lack of debate, as well as the pressing need for discussion of these current issues nationwide.

Immediate Decision-Making and Information Needs in Intensive Care Coordination

The aim of this study was to develop a theoretical model for information integration to support the deci¬sion making of intensive care charge nurses, and physicians in charge – that is, ICU shift leaders. The study focused on the ad hoc decision-making and immediate information needs of shift leaders during the management of an intensive care unit’s (ICU) daily activities. The term ‘ad hoc decision-making’ was defined as critical judgements that are needed for a specific purpose at a precise moment with the goal of ensuring instant and adequate patient care and a fluent flow of ICU activities. Data collection and research analysis methods were tested in the identification of ICU shift leaders’ ad hoc decision-making. Decision-making of ICU charge nurses (n = 12) and physicians in charge (n = 8) was observed using a think-aloud technique in two university-affiliated Finnish ICUs for adults. The ad hoc decisions of ICU shift leaders were identified using an application of protocol analysis. In the next phase, a structured online question¬naire was developed to evaluate the immediate information needs of ICU shift leaders. A national survey was conducted in all Finnish, university-affiliated hospital ICUs for adults (n = 17). The questionnaire was sent to all charge nurses (n = 515) and physicians in charge (n = 223). Altogether, 257 charge nurses (50%) and 96 physicians in charge (43%) responded to the survey. The survey was also tested internationally in 16 Greek ICUs. From Greece, 50 charge nurses out of 240 (21%) responded to the survey. A think-aloud technique and protocol analysis were found to be applicable for the identification of the ad hoc decision-making of ICU shift leaders. During one day shift leaders made over 200 ad hoc decisions. Ad hoc decisions were made horizontally, related to the whole intensive care process, and vertically, concerning single intensive care incidents. Most of the ICU shift leaders’ ad hoc decisions were related to human resources and know-how, patient information and vital signs, and special treatments. Commonly, this ad hoc decision-making involved several multiprofessional decisions that constituted a bundle of immediate decisions and various information needs. Some of these immediate information needs were shared between the charge nurses and the physicians in charge. The majority of which concerned patient admission, the organisation and management of work, and staff allocation. In general, the information needs of charge nurses were more varied than those of physicians. It was found that many ad hoc deci-sions made by the physicians in charge produced several information needs for ICU charge nurses. This meant that before the task at hand was completed, various kinds of information was sought by the charge nurses to support the decision-making process. Most of the immediate information needs of charge nurses were related to the organisation and management of work and human resources, whereas the information needs of the physicians in charge mainly concerned direct patient care. Thus, information needs differ between professionals even if the goal of decision-making is the same. The results of the international survey confirmed these study results for charge nurses. Both in Finland and in Greece the information needs of charge nurses focused on the organisation and management of work and human resources. Many of the most crucial information needs of Finnish and Greek ICU charge nurses were common. In conclusion, it was found that ICU shift leaders make hundreds of ad hoc decisions during the course of a day related to the allocation of resources and organisation of patient care. The ad hoc decision-making of ICU shift leaders is a complex multi-professional process, which requires a lot of immediate information. Real-time support for information related to patient admission, the organisation and man¬agement of work, and allocation of staff resources is especially needed. The preliminary information integration model can be applied when real-time enterprise resource planning systems are developed for intensive care daily management

Mapping the translation needs and practices in development co-operation projects of NGOs

Tämän pro gradu -tutkielman aiheena on kääntäminen ja viestintä vieraalla kielellä Suomen ulkoasiainministeriön rahoittamissa kansalaisjärjestöjen kehitysyhteistyöhankkeissa. Tutkielman on tarkoitus kartoittaa kyseisten kehitysyhteistyöhankkeiden kääntämiseen ja vieraskieliseen viestintään liittyviä tarpeita ja -käytäntöjä. Aihetta ei ole tutkittu laajasti muutoin, joten empiirinen osuus on erityisen merkittävässä roolissa. Tutkielman alussa esitellään ulkoasiainministeriön laatimia suomalaisten kansalaisjärjestöjen kehitysyhteistyöhankkeiden ehtoja ja ohjeita, jotka ovat kyseiselle tutkimukselle olennaisia. Tutkielman teoreettinen osuus koostuu lähinnä metodologisesta pohdinnasta, koska aiempaa tutkimustietoa on vähän. Tutkimusmetodien analysointia on painotettu myös siksi, että empiirisellä osuudella on niin suuri merkitys. Tutkielman empiirinen aineisto on yhtäältä peräisin tutkijan havainnoista, jotka saatiin omia varhaisempia hankehallinnointikokemuksia hyödyntäen sekä osallistuvan havainnoinnin menetelmää käyttäen kahden opiskelijajärjestön kehitysyhteistyöhankkeista vuosien 2009 ja 2012 välisenä aikana. Toisaalta aineisto on kerätty kyselytutkimuksen vastauksista. Kysely lähetettiin 35 suomalaiselle kansalaisjärjestölle, joiden kehitysyhteistyöhankkeita Suomen ulkoasiainministeriö rahoittaa. Järjestöt valittiin satunnaisotannalla. Empiirisen aineiston analyysistä ilmeni muun muassa, että tutkijan alkuperäinen hypoteesi kehitysyhteistyöhön liittyvien tekstien kääntämisen yleisyydestä pitää osittain paikkansa, vaikka tekstejä käännettiinkin kansalaisjärjestöissä vähemmän kuin tutkija odotti. Tutkimusaineisto ei ole kuitenkaan tarpeeksi laaja, jotta tuloksia voitaisiin yleistää, sillä kansalaisjärjestöt, niiden hankkeet, käännöstarpeet ja asiantuntemus osoittautuivat odotetusti hyvin erilaisiksi. Tulokset sisältävät asiaa myös esimerkiksi järjestöissä kääntävien ja vieraalla kielellä viestivien taustoista. Jatkotutkimukset ovat kuitenkin tarpeen, ja mahdollisia tutkimusaiheita on runsaasti.

Toward a-state-of-the-art IR copyright management system: a needs assessment

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

Expectations, frames and practices of genetic counselling in different contexts of genetic testing

Genetic counselling is a process in which the counsellee receives information and support concerning a genetic disease. This study examines the genetic counselling attached to genetic testing. Since genetic information is increasing alongside new testing technologies and the situations faced at the genetic clinics will therefore be more diverse, it is essential to assess what the expectations directed at genetic counselling are. It is also important to compare how they face the current counselling practices. In this study, the expectations, frames and practices of genetic counselling in different contexts of genetic testing were examined from three different perspectives: First, international guidelines covering genetic counselling were analysed to summarise what is expected from genetic counselling and to study how genetic information is framed. Second, national experts in European countries were asked about the regulations and practices of genetic counselling in their country. Finally, ten counsellees who had visited a genetic clinic were interviewed to analyse their expectations and experiences. The counsellees’ perspective was also approached through the background review of the previous studies on counsellees’ experiences. On the basis of the study, there are basic elements that are expected to be covered in genetic counselling from all perspectives. However, the views concerning bioethics, genetic exceptionalism and psychosocial aspects vary depending on the perspective and on the individual situation. Since there are sometimes more differences than similarities between genetic tests, no universal recommendations for counselling can be applied. The practices of genetic counselling should be defined situationally, emphasising the individual needs over the genes.

Focus on the user: perception, expectations and needs

Esitys KDK-käytettävyystyöryhmän järjestämässä seminaarissa: Miten käyttäjien toiveet haastavat metatietokäytäntöjämme? / How users' expectations challenge our metadata practices? 30.9.2014.

The requirements and needs of global data usage in product lifecycle management

This study was done for ABB Ltd. Motors and Generators business unit in Helsinki. In this study, global data movement in large businesses is examined from a product data management (PDM) and enterprise resource planning (ERP) point-of-view. The purpose of this study was to understand and map out how a large global business handles its data in a multiple site structure and how it can be applied in practice. This was done by doing an empirical interview study on five different global businesses with design locations in multiple countries. Their master data management (MDM) solutions were inspected and analyzed to understand which solution would best benefit a large global architecture with many design locations. One working solution is a transactional hub which negates the effects of multisite transfers and reduces lead times. Also, the requirements and limitations of the current MDM architecture were analyzed and possible reform ideas given.  

Forest inventory information needs in Northwest Russia

This thesis applies the customer value hierarchy model to forestry in order to determine strategic options to enhance the value of LiDAR technology in Russian forestry. The study is conducted as a qualitative case study with semi-structured interviews as a main source of the primary data. The customer value hierarchy model constitutes a theoretical base for the research. Secondary data incorporates information on forest resource management, LiDAR technology and Russian forestry. The model is operationalised using forestry literature and forms a basis for analyses of primary data. Analyses of primary data coupled with comprehension of Russian forest inventory system and knowledge on global forest inventory have led to conclusions on the forest inventory methods selection criteria and the organizations that would benefit the most from LiDAR technology use. The thesis recommends strategic options for LiDAR technology’s value enhancement in Russian forestry.

Forest inventory information needs in Northwest Russia

This research report applies the customer value hierarchy model to forestry in order to determine strategic options to enhance the value of LiDAR technology in Russian forestry. The study is conducted as a qualitative case study with semi-structured interviews as a main source of the primary data. The customer value hierarchy model constitutes a theoretical base for the research. Secondary data incorporates information on forest resource management, LiDAR technology and Russian forestry. The model is operationalised using forestry literature and forms a basis for analyses of primary data. Analyses of primary data coupled with comprehension of Russian forest inventory system and knowledge on global forest inventory have led to conclusions on the forest inventory methods selection criteria and the organizations that would benefit the most from LiDAR technology use. The report recommends strategic options for LiDAR technology’s value enhancement in Russian forestry. This work has been conducted as a part of the project ‘Finnish-Russian Forest Academy 2 - Exploiting and Piloting’, which has been supported financially by the South-East Finland- Russia ENPI CBC 2007-2014 Programme.

Bully-victims: Prevalence, psychosocial adjustment, and responsiveness to intervention

In this thesis, a unique subgroup involved in the bullying phenomenon, the bully-victims, are identified and examined. Despite the increasing attention on the bully-victims in recent years, their prevalence, psychosocial adjustment, and response to anti-bullying programs has not been clearly determined. Three empirical studies were conducted in this thesis to examine the prevalence of bully-victims. Moreover, in study I, the psychosocial adjustment of bully-victims was compared with that of pure bullies, pure victims, and non-involved students. In study II, different forms of bullying and victimization were compared among pure bullies, pure victims, bully-victims, and non-involved students. In study III, the effectiveness of anti-bullying programs, in particular, the KiVa program, on bully-victims was demonstrated. Overall, bully-victims formed the smallest group comparing with pure bullies, pure victims, and non-involved students, and in general differed from pure bullies rather than pure victims in terms of subjective experience of maladjustment. They employed more verbal, physical, and cyberbullying perpetration, but not indirect bullying; and they were more victimized by verbal, physical, cyber, and indirect bullying. The KiVa anti-bullying program in Finland is effective in reducing the prevalence of bully-victims.

The functional fit between collaborative software and work systems:Qualification of work system needs to software functionality

The study develops an approach that tries to validate software functionality to work systems needs in SMEs. The formulated approach is constructed by using a SAAS based software i.e., work collaboration service (WCS), and SMEs as the elements of study. Where the WCS’s functionality is qualified to the collaboration needs that exist in operational and project work within SMEs. For this research constructivist approach and case study method is selected because the nature of the current study requires an in depth study of the work collaboration service as well as a detailed study of the work systems within different enterprises. Four different companies are selected in which fourteen interviews are conducted to gather data pertaining. The work systems method and framework are used as a central part of the approach to collect, analyze and interpret the enterprises work systems model and the underlying collaboration needs on operational and project work. On the other hand, the functional model of the WCS and its functionality is determined from functional model analysis, software testing, documentation and meetings with the service vendor. The enterprise work system model and the WCS model are compared to reveal how work progression differs between the two and make visible unaddressed stages of work progression. The WCS functionality is compared to work systems collaboration needs to ascertain if the service will suffice the needs of the project and operational work under study. The unaddressed needs provide opportunities to improve the functionality of the service for better conformity to the needs of enterprise and work. The results revealed that the functional models actually differed in how operational and project work progressed within the stages. WCS shared similar stages of work progression apart from the stages of identification and acceptance, and progress and completion stages were only partially addressed. Conclusion is that the identified unaddressed needs such as, single point of reference, SLA and OLA inclusion etc., should be implemented or improved within the WCS at appropriate stages of work to gain better compliance of the service to the needs of the enterprise an work itself. The developed approach can hence be used to carry out similar analysis for the conformance of pre-built software functionality to work system needs with SMEs.