The role of Bluetooth technology in transforming the value network of ICT industry

Tutkimuksen tavoitteena oli selvittää miten Bluetooth-teknologia voi vaikuttaa ICT-alan arvoverkkoon ja alan toimijoiden rooleihin. Tutkimuksessa käytettiin kvalitatiivisia menetelmiä ja siinä oli piirteitä tulevaisuuden tutkimuksesta, koska myös eksploratiivisia menetelmiä käytettiin. Tutkimus perustui laajalti kirjallisuuteen ja artikkeleihin, joiden perusteella muodostettiin skenaarioita ICT-alan tulevaisuuden arvoverkosta. Tutkimus sisälsi myös empiirisen osion, jossa järjestettiin kaksi ryhmäkeskustelua, joissa alan toimijat keskustelivat muodostetuista skenaarioista sekä yleisemmin Bluetoothin vaikutuksista arvoverkkoon. Tutkimuksen mukaan ICT-alan arvoverkko tulevaisuudessa on rakenteeltaan strateginen arvoverkko, jota johtaa eri toimija erilaisissa markkinatilanteissa. Verkon strateginen keskus voi muuttua ajan kuluessa kun Bluetoothin sovelluskohteet lisääntyvät ja se voi vaihdella markkina-alueesta toiseen. Bluetooth luo uuden kommunikaatiokanavan nykyisten rinnalle ja se voi paikallisesti korvata nykyisten kanavien käytön tiedon siirrossa. Bluetooth voi synnyttää lukuisia uusia liiketoimintamahdollisuuksia ja sen avulla voidaan tuottaa lisäarvopalveluita. Suurimpien muutosten voidaan olettaa koskevan teleoperaattoreiden ja sisällöntuottajien liiketoimintaa.

Digital printing delivering value to the value network: CASE: STORA ENSO OYJ

Tutkielman tavoitteena oli tutkia, millaista arvoa digitaalinen painatusmenetelmä tuo yrityksen arvoverkostoon. Teoriaosassa tavoite oli rakentaa digitaalipainatuksen arvoverkostoa tutkien kirjallisuutta liittyen arvoketju- ja arvoverkostoajatteluun. Myös aiemmat tutkimukset ja kirjallisuus liittyen digitaalipainatukseen rakensivat osaltaan teoreettisen viitekehyksen muodostumista. Aiemmat tutkimukset digitaalisen painomenetelmän mahdollisuuksista ovat hyvin tekniikkapainotteisia, siksi tämä tutkimus liittyy enemmän kaupallisiin mahdollisuuksiin. Empiirinen osio tutkimuksesta tehtiin kvalitatiivisena case -tutkimuksena, johon sisältyi yksi alayksikkö. Eli tutkittiin yhtä casea, jossa oli kaksi osapuolta. Tutkielma liittyy kiinteästi Stora Enson ja Valion väliseen digipainatus-projektiin, joka käynnistettiin helmikuussa 2001. Tutkielman teemahaastatteluihin valittiin henkilöt tästä projektiryhmästä. Projektiryhmän mielipiteitä ja havaintoja hyödyntäen pyrittiin löytämään tukea ja eroavaisuuksia teoriaosan muodostamaan viitekehykseen ja informaatioon. Empiirinen osuus tuki teoriaosassa esittämiä väittämiä hyvin, mutta myös muutamia uusia havaintoja esiintyi. Tutkimusongelmaan löydettiin monia vastauksia: digitaalipainatus luo arvoa yrityksen jakeluketjuun vähentämällä varastoja ja nopeuttamalla toimituksia. Jäätelöpakkausten markkinointi on aivan uuden haasteen edessä, koska mahdollisuudet kasvavat digitaalipainatuksen myötä huomattavasti. Kartongin valmistajalle arvo tulee parempien tuotteiden kautta, joista saa myös paremman tuoton. Digitaalipainatuksen arvoverkostossa tulee tapahtumaan muutoksia jatkossa, eri osapuolten roolit saattavat muuttua radikaalisti. Kuka hoitaa painatusta ja miten?

Development process and initial validation of the ethical conflict in nursing questionnaire-critical care version

Background: Ethical conflicts are arising as a result of the growing complexity of clinical care, coupled with technological advances. Most studies that have developed instruments for measuring ethical conflict base their measures on the variables"frequency" and"degree of conflict". In our view, however, these variables are insufficient for explaining the root of ethical conflicts. Consequently, the present study formulates a conceptual model that also includes the variable"exposure to conflict", as well as considering six"types of ethical conflict". An instrument was then designed to measure the ethical conflicts experienced by nurses who work with critical care patients. The paper describes the development process and validation of this instrument, the Ethical Conflict in Nursing Questionnaire Critical Care Version (ECNQ-CCV). Methods: The sample comprised 205 nursing professionals from the critical care units of two hospitals in Barcelona (Spain). The ECNQ-CCV presents 19 nursing scenarios with the potential to produce ethical conflict in the critical care setting. Exposure to ethical conflict was assessed by means of the Index of Exposure to Ethical Conflict (IEEC), a specific index developed to provide a reference value for each respondent by combining the intensity and frequency of occurrence of each scenario featured in the ECNQ-CCV. Following content validity, construct validity was assessed by means of Exploratory Factor Analysis (EFA), while Cronbach"s alpha was used to evaluate the instrument"s reliability. All analyses were performed using the statistical software PASW v19. Results: Cronbach"s alpha for the ECNQ-CCV as a whole was 0.882, which is higher than the values reported for certain other related instruments. The EFA suggested a unidimensional structure, with one component accounting for 33.41% of the explained variance. Conclusions: The ECNQ-CCV is shown to a valid and reliable instrument for use in critical care units. Its structure is such that the four variables on which our model of ethical conflict is based may be studied separately or in combination. The critical care nurses in this sample present moderate levels of exposure to ethical conflict. This study represents the first evaluation of the ECNQ-CCV.

Development process and initial validation of the ethical conflict in nursing questionnaire-critical care version

Background: Ethical conflicts are arising as a result of the growing complexity of clinical care, coupled with technological advances. Most studies that have developed instruments for measuring ethical conflict base their measures on the variables"frequency" and"degree of conflict". In our view, however, these variables are insufficient for explaining the root of ethical conflicts. Consequently, the present study formulates a conceptual model that also includes the variable"exposure to conflict", as well as considering six"types of ethical conflict". An instrument was then designed to measure the ethical conflicts experienced by nurses who work with critical care patients. The paper describes the development process and validation of this instrument, the Ethical Conflict in Nursing Questionnaire Critical Care Version (ECNQ-CCV). Methods: The sample comprised 205 nursing professionals from the critical care units of two hospitals in Barcelona (Spain). The ECNQ-CCV presents 19 nursing scenarios with the potential to produce ethical conflict in the critical care setting. Exposure to ethical conflict was assessed by means of the Index of Exposure to Ethical Conflict (IEEC), a specific index developed to provide a reference value for each respondent by combining the intensity and frequency of occurrence of each scenario featured in the ECNQ-CCV. Following content validity, construct validity was assessed by means of Exploratory Factor Analysis (EFA), while Cronbach"s alpha was used to evaluate the instrument"s reliability. All analyses were performed using the statistical software PASW v19. Results: Cronbach"s alpha for the ECNQ-CCV as a whole was 0.882, which is higher than the values reported for certain other related instruments. The EFA suggested a unidimensional structure, with one component accounting for 33.41% of the explained variance. Conclusions: The ECNQ-CCV is shown to a valid and reliable instrument for use in critical care units. Its structure is such that the four variables on which our model of ethical conflict is based may be studied separately or in combination. The critical care nurses in this sample present moderate levels of exposure to ethical conflict. This study represents the first evaluation of the ECNQ-CCV.

CSF lactate for accurate diagnosis of community-acquired bacterial meningitis.

CSF lactate measurement is recommended when nosocomial meningitis is suspected, but its value in community-acquired bacterial meningitis is controversial. We evaluated the diagnostic performance of lactate and other CSF parameters in a prospective cohort of adult patients with acute meningitis. Diagnostic accuracy of lactate and other CSF parameters in patients with microbiologically documented episodes was assessed by receiver operating characteristic (ROC) curves. The cut-offs with the best diagnostic performance were determined. Forty-five of 61 patients (74%) had a documented bacterial (n = 18; S. pneumoniae, 11; N. meningitidis, 5; other, 2) or viral (n = 27 enterovirus, 21; VZV, 3; other, 3) etiology. CSF parameters were significantly different in bacterial vs. viral meningitis, respectively (p < 0.001 for all comparisons): white cell count (median 1333 vs. 143/mm(3)), proteins (median 4115 vs. 829 mg/l), CSF/blood glucose ratio (median 0.1 vs. 0.52), lactate (median 13 vs. 2.3 mmol/l). ROC curve analysis showed that CSF lactate had the highest accuracy for discriminating bacterial from viral meningitis, with a cutoff set at 3.5 mmol/l providing 100% sensitivity, specificity, PPV, NPV, and efficiency. CSF lactate had the best accuracy for discriminating bacterial from viral meningitis and should be included in the initial diagnostic workup of this condition.

Le stress chez l'aidant naturel dont le proche est en traitement initial d'un cancer du poumon

Le cancer du poumon fait partie des cancers les plus fréquents. Diagnostiqué à un stade souvent tardif, il se caractérise par un mauvais pronostic et de lourdes répercussions sur la santé du patient. La phase de traitement initial représente un moment critique où les proches du patient deviennent aidants naturels du patient et endossent de nouvelles responsabilités. Cette situation génère des conséquences en termes de stress chez l'aidant naturel. Le but de cette étude était de décrire l'importance du stress chez l'aidant naturel du patient en traitement initial pour un cancer du poumon. L'approche méthodologique utilisée est de type descriptif transversal. L'échantillon de convenance était composé de 28 aidants naturels et 26 patients en traitement initial pour un cancer du poumon suivis dans un centre d'oncologie ambulatoire universitaire en Suisse. L'importance du stress des aidants naturels a été évaluée à partir de l'instrument Caregiver Reaction Assessment (CRA) de Given et al. (1992) complété d'une question mesurant la perception du manque d'information. Le CRA mesure le ressenti de l'aidant naturel face aux dimensions négatives et positive du stress sur une échelle de type Likert à cinq points. Le modèle des systèmes de Neuman (2002) a servi de cadre théorique à l'étude. Les aidants naturels ont accordé une importance plus élevée (score moyen 4,15) à l'Estime de soi, dimension positive du stress qu'aux dimensions négatives. Parmi celles-ci, la Perturbation des activités représente la dimension qui affecte le plus le quotidien des aidants (score moyen 2,96). Les caractéristiques sociodémographiques de l'aidant et les données médicales du patient, semblent avoir une influence sur l'importance du stress perçu, mais d'autres marqueurs objectifs doivent être identifiés pour affiner l'interprétation de ces relations. Une grande majorité (78%) des aidants ont indiqué qu'ils disposaient d'assez d'information pour soigner, indiquant que l'information est un sujet important dans leur vécu et mérite une évaluation plus poussée en tant que dimension du stress associé au rôle d'aidant naturel. L'infirmière doit viser par ses actions à préserver l'intégrité et la stabilité de la santé de l'aidant naturel comme elle le fait pour les patients. L'investigation systématique du stress représente une intervention prioritaire chez les aidants naturels dans le contexte oncologique. Des interventions personnalisées pourront être ainsi développées, afin de soutenir l'aidant naturel dans ses activités d'aide auprès de son proche tout en préservant sa propre santé.

Prognostic value of PCSK9 levels in patients with acute coronary syndromes.

AIMS: Proprotein convertase subtilisin kexin 9 (PCSK9) is an emerging target for the treatment of hypercholesterolaemia, but the clinical utility of PCSK9 levels to guide treatment is unknown. We aimed to prospectively assess the prognostic value of plasma PCSK9 levels in patients with acute coronary syndromes (ACS). METHODS AND RESULTS: Plasma PCSK9 levels were measured in 2030 ACS patients undergoing coronary angiography in a Swiss prospective cohort. At 1 year, the association between PCSK9 tertiles and all-cause death was assessed adjusting for the Global Registry of Acute Coronary Events (GRACE) variables, as well as the achievement of LDL cholesterol targets of <1.8 mmol/L. Patients with higher PCSK9 levels at angiography were more likely to have clinical familial hypercholesterolaemia (rate ratio, RR 1.21, 95% confidence interval, CI 1.09-1.53), be treated with lipid-lowering therapy (RR 1.46, 95% CI 1.30-1.63), present with longer time interval of chest pain (RR 1.29, 95% CI 1.09-1.53) and higher C-reactive protein levels (RR 1.22, 95% CI 1.16-1.30). PCSK9 increased 12-24 h after ACS (374 ± 149 vs. 323 ± 134 ng/mL, P < 0.001). At 1 year follow-up, HRs for upper vs. lower PCSK9-level tertiles were 1.13 (95% CI 0.69-1.85) for all-cause death and remained similar after adjustment for the GRACE score. Patients with higher PCSK9 levels were less likely to reach the recommended LDL cholesterol targets (RR 0.81, 95% CI 0.66-0.99). CONCLUSION: In ACS patients, high initial PCSK9 plasma levels were associated with inflammation in the acute phase and hypercholesterolaemia, but did not predict mortality at 1 year.

Care delivery value chains for ophthalmic clinics in Switzerland

Perceived patient value is often not aligned with the emerging expenses for health care services. In other words, the costs are often supposed as rising faster than the actual value for the patients. This fact is causing major concerns to governments, health plans, and individuals. Attempts to solve the problem have habitually been on the operational effectiveness side: increasing patient volume, minimizing costs, rationing, or closing hospitals, usually resulting in a zero-sum game. Only few approaches come from the strategic positioning side and "competition" among hospitals is still perceived rather as a danger than as a chance to create a positive-sum game and stimulate patient value. In their 2006 book, "Redefining Health Care", the renowned Harvard strategy professor Michael E. Porter and hospital management expert Professor Elizabeth Olmsted Teisberg approach the challenge from the positive-sum perspective: they propose to form Integrated Practice Units (IPUs) and manage hospitals in a modern, patient value oriented way. They argue that creating value-based competition on results should have the same effect on the health care sector like transparency and competition turned other industries with out-dated management models (like recently the inert telecommunication industry) into highly competitive and customer value creating businesses. The objective of this paper is to elaborate Care Delivery Value Chains for Integrated Practice Units in ophthalmic clinics and gather a first feedback from Swiss hospital managers, ophthalmologists, and patients, if such an approach could be a realistic way to improve health care management. First, Porter's definition of competitiveness (distinction between operational effectiveness and strategic positioning) is explained. Then, the Care Delivery Value Chain is introduced as a key element for understanding value-based management, followed by three practice examples for ophthalmic clinics. Finally, recommendations are given how the Care Delivery Value Chain can be managed efficiently and how the obstacles of becoming a patient-oriented organization can be overcome. The conclusion is that increased transparency and value-based competition on results has the potential to change the mindset of hospital managers-which will align patient value with the emerging health care expenses. Early adapters of this management approach will gain a competitive advantage. [Author, p. 6]

Receiver operating characteristic (ROC) curve for classification of18F-NaF uptake on PET/CT

Abstract Objective: To assess the cutoff values established by ROC curves to classify18F-NaF uptake as normal or malignant. Materials and Methods: PET/CT images were acquired 1 hour after administration of 185 MBq of18F-NaF. Volumes of interest (VOIs) were drawn on three regions of the skeleton as follows: proximal right humerus diaphysis (HD), proximal right femoral diaphysis (FD) and first vertebral body (VB1), in a total of 254 patients, totalling 762 VOIs. The uptake in the VOIs was classified as normal or malignant on the basis of the radiopharmaceutical distribution pattern and of the CT images. A total of 675 volumes were classified as normal and 52 were classified as malignant. Thirty-five VOIs classified as indeterminate or nonmalignant lesions were excluded from analysis. The standardized uptake value (SUV) measured on the VOIs were plotted on an ROC curve for each one of the three regions. The area under the ROC (AUC) as well as the best cutoff SUVs to classify the VOIs were calculated. The best cutoff values were established as the ones with higher result of the sum of sensitivity and specificity. Results: The AUCs were 0.933, 0.889 and 0.975 for UD, FD and VB1, respectively. The best SUV cutoffs were 9.0 (sensitivity: 73%; specificity: 99%), 8.4 (sensitivity: 79%; specificity: 94%) and 21.0 (sensitivity: 93%; specificity: 95%) for UD, FD and VB1, respectively. Conclusion: The best cutoff value varies according to bone region of analysis and it is not possible to establish one value for the whole body.

Cultural Diffusion Was the Main Driving Mechanism of the Neolithic Transition in Southern Africa

It is well known that the Neolithic transition spread across Europe at a speed of about 1 km/yr. This result has been previously interpreted as a range expansion of the Neolithic driven mainly by demic diffusion (whereas cultural diffusion played a secondary role). However, a long-standing problem is whether this value (1 km/yr) and its interpretation (mainly demic diffusion) are characteristic only of Europe or universal (i.e. intrinsic features of Neolithic transitions all over the world). So far Neolithic spread rates outside Europe have been barely measured, and Neolithic spread rates substantially faster than 1 km/yr have not been previously reported. Here we show that the transition from hunting and gathering into herding in southern Africa spread at a rate of about 2.4 km/yr, i.e. about twice faster than the European Neolithic transition. Thus the value 1 km/yr is not a universal feature of Neolithic transitions in the world. Resorting to a recent demic-cultural wave-of-advance model, we also find that the main mechanism at work in the southern African Neolithic spread was cultural diffusion (whereas demic diffusion played a secondary role). This is in sharp contrast to the European Neolithic. Our results further suggest that Neolithic spread rates could be mainly driven by cultural diffusion in cases where the final state of this transition is herding/pastoralism (such as in southern Africa) rather than farming and stockbreeding (as in Europe)

Chemical characterization of tin-lead glazed pottery from the Iberian Peninsula and the Canary Islands: initial steps toward a better understanding of Spanish Colonial pottery in Americas

Majolica pottery was the most characteristic tableware produced in Europe during the Medieval and Renaissance periods. Because of the prestige and importance attributed to this ware, Spanish majolica was imported in vast quantities into the Americas during the Spanish Colonial period. A study of Spanish majolica was conducted on a set of 186 samples from the 10 primary majolica production centres on the Iberian Peninsula and 22 sherds from two early colonial archaeological sites on the Canary Islands. The samples were analysed by neutron activation analysis (NAA), and the resulting data were interpreted using an array of multivariate statistical approaches. Our results show a clear discrimination between different production centres, allowing a reliable provenance attribution of the sherds from the Canary Islands.

Retrieval of kinetic rates in reactions with semi batch liquid phase using ill-posed inverse problem theory

A neural network procedure to solve inverse chemical kinetic problems is discussed in this work. Rate constants are calculated from the product concentration of an irreversible consecutive reaction: the hydrogenation of Citral molecule, a process with industrial interest. Simulated and experimental data are considered. Errors in the simulated data, up to 7% in the concentrations, were assumed to investigate the robustness of the inverse procedure. Also, the proposed method is compared with two common methods in nonlinear analysis; the Simplex and Levenberg-Marquardt approaches. In all situations investigated, the neural network approach was numerically stable and robust with respect to deviations in the initial conditions or experimental noises.

A proposal for a repertoire of software testing methods

Nowadays software testing and quality assurance have a great value in software development process. Software testing does not mean a concrete discipline, it is the process of validation and verification that starts from the idea of future product and finishes at the end of product’s maintenance. The importance of software testing methods and tools that can be applied on different testing phases is highly stressed in industry. The initial objectives for this thesis were to provide a sufficient literature review on different testing phases and for each of the phases define the method that can be effectively used for improving software’s quality. Software testing phases, chosen for study are: unit testing, integration testing, functional testing, system testing, acceptance testing and usability testing. The research showed that there are many software testing methods that can be applied at different phases and in the most of the cases the choice of the method should be done depending on software type and its specification. In the thesis the problem, concerned to each of the phases was identified; the method that can help in eliminating this problem was suggested and particularly described.

The value of digitalization of services in the new service development

The purpose of this thesis is to study factors that have an impact on the company’s capabilities to identify and analyze the value of digitalization of services during the early stages of service development process and evaluate them from the perspective of a case company. The research problem was defined: “How digitalization of services affects delivering the services of the future?” The research method of this thesis was based on the qualitative case study which aimed to study both company’s and customer’s set of values. The study included a literature review and a development study. The empirical research part consisted of analyzing three existing services, specifying a new digital service concept and its feasibility analysis as part of a business requirement phase. To understand the set of values, 10 stakeholder interviews were conducted and earlier customer surveys were utilized, and additionally, a number of meetings were conducted with the case company representatives to develop service concept, and evaluate the findings. The impact of the early stages of service development process discovered to reflect directly in the capabilities of the case company to identify and create customer value were related to the themes presented in the literature review. In order to specify the value achieved from the digitalization the following areas of strategic background elements were deepened during the study: Innovations, customer understanding and business service. Based on the findings, the study aims to enhance the case company’s capability to identify and evaluate the impact of the digitalization in delivering services of the future. Recognizing the value of digital service before the beginning of the development project is important to the businesses of both customer and provider. By exploring the various levels of digitalization one can get the overall picture of the value gained from utilizing digital opportunities. From the development perspective, the process of reviewing and discovering the most promising opportunities and solutions is the key step in order to deliver superior services. Ultimately, a company should understand the value outcome determination of the individual services as well as their digital counterparts.

Social ventures : the development of the theory of sustainable contributive advantage and initial empirical tests

This thesis attempts to fill gaps in both a theoretical basis and an operational and strategic understanding in the areas of social ventures, social entrepreneurship and nonprofit business models. This study also attempts to bridge the gap in strategic and economic theory between social and commercial ventures. More specifically, this thesis explores sustainable competitive advantage from a resource-based theory perspective and explores how it may be applied to the nonmarket situation of nonprofit organizations and social ventures. It is proposed that a social value-orientation of sustainable competitive advantage, called sustainable contributive advantage, provides a more realistic depiction of what is necessary in order for a social venture to perform better than its competitors over time. In addition to providing this realistic depiction, this research provides a substantial theoretical contribution in the area of economics, social ventures, and strategy research, specifically in regards to resource-based theory. The proposed model for sustainable contributive advantage uses resource-based theory and competitive advantage in order to be applicable to social ventures. This model proposes an explanation of a social venture’s ability to demonstrate consistently superior performance. In order to determine whether sustainable competitive advantage is in fact, appropriate to apply to both social and economic environments, quantitative analyses are conducted on a large sample of nonprofit organizations in a single industry and then compared to similar quantitative analyses conducted on commercial ventures. In comparing the trends and strategies between the two types of entities from a quantitative perspective, propositions are developed regarding a social venture’s resource utilization strategies and their possible impact on performance. Evidence is found to support the necessity of adjusting existing models in resource-based theory in order to apply them to social ventures. Additionally supported is the proposed theory of sustainable contributive advantage. The thesis concludes with recommendations for practitioners, researchers and policy makers as well as suggestions for future research paths.