Impact of maternity care policy in Catalonia: a retrospective cross-sectional study of service delivery in public and private hospitals

Background: As a result of the growing number of interventions that are now performed in the context of maternity care, health authorities have begun to examine the possible repercussions for service provision and for maternal and neonatal health. In Spain the Strategy Paper on Normal Childbirth was published in 2008, and since then the authorities in Catalonia have sought to implement its recommendations. This paper reviews the current provision of maternity care in Catalonia. Methods: This was a descriptive study. Hospitals were grouped according to their source of funding (public or private) and were stratified (across four strata) on the basis of the annual number of births recorded within their respective maternity service. Data regarding the distribution of obstetric professionals were taken from an official government survey of hospitals published in 2010. The data on obstetric interventions (caesarean, use of forceps, vacuum or non-specified instruments) performed in 2007, 2010 and 2012 were obtained by consulting discharge records of 44 public and 20 private hospitals, which together provide care in 98% of all births in Catalonia. Proportions and confidence intervals were calculated for each intervention performed in all full-term (3742 weeks) singleton births. Results: Analysis of staff profiles according to the stratification of hospitals showed that almost all the hospitals had more obstetricians than midwives among their maternity care staff. Public hospitals performed fewer caesareans [range between 19.20% (CI 18.84-19.55) and 28.14% (CI 27.73-28.54)] than did private hospitals [range between 32.21% (CI 31.78-32.63) and 39.43% (CI 38.98-39.87)]. The use of forceps has decreased in public hospitals. The use of a vacuum extractor has increased and is more common in private hospitals. Conclusions: Caesarean section is the most common obstetric intervention performed during full-term singleton births in Catalonia. The observed trend is stable in the group of public hospitals, but shows signs of a rise among private institutions. The number of caesareans performed in accredited public hospitals covers a limited range with a stable trend. Among public hospitals the highest rate of caesareans is found in non-accredited hospitals with a lower annual number of births.

Success of service-intensive manufacturing firms - resource-based view

The main objective of this study is to examine the relationships between resources, competitive advantage and firm success. The study focuses, on one hand, on the financial performance of service-intensive manufac-turing firms against competitors with a lower service intensity and, on the other hand, on the resources as drivers for competitive advantage and success. The purpose of the theoretical part is to link the study in the field of the strategy research. The empirical part of the study is based on the quantitative analyses of the survey data collected from 50 major suppliers of industrial machinery and transportation equipment in Europe and North America. Results indicate that service-intensive manufacturing firms have performed better and their performance has been more stable vis-à-vis their peers. The main resources that differentiate service-intensive manufacturing firms from their non-service intensive competitors are service strategy and service-oriented top management. The analyses on the VRIO resources produced only a limited amount of information and solely service-centred culture appeared to be a rent generating resource.

Smart homes as service platforms. Research report of ÄLYKOP sub-project “Competitive advantage from customer value”

In this report, we summarize results of our part of the ÄLYKOP-project on customer value creation in the intersection of the health care, ICT, forest and energy industries. The research directs to describe how industry transformation and convergence create new possibilities, business opportunities and even new industries.The report consists of findings which are presented former in academic publications. The publication discusses on customer value, service provision and resource basis of the novel concepts through multiple theorethical frameworks. The report is divided into three maim sections which are theoretical background, discussion on health care industry and evaluations regarding novel smart home concepts. Transaction cost economics and Resource- Based view on the firm provides the theoretical basis to analyze the prescribed phenomena. The health care industry analysis describes the most important changes in the demand conditions of health care services, and explores the features that are likely to open new business opportunities for a solution provider. The third part of the report on the smart home business provides illustrations few potential concepts that can be considered to provide solutions to economical problems which arise from aging of population. The results provide several recommendations for the smart home platform developers in public and private sectors. By the analysis, public organizations dominate service provision and private markets are emergent state at present. We argue that public-private partnerships are nececssary for creating key suppliers. Indeed, paying attion on appropriate regulation, service specifications and technology standards would foster diffusion of new services. The dynamics of the service provision networks is driven by need for new capabiltities which are required for adapting business concepts to new competitive situation. Finally, the smart home framework revealed links between conventionally distant business areas such as health care and energy distribution. The platform integrates functionalities different for purposes which however apply same resource basis.

Construction Plan Image Service for Mobile Devices

The forthcoming media revolution of exchanging paper documents to digital media in construction engineering requires new tools to be developed. The basis of this bachelor’s thesis was to explore the preliminary possibilities of exporting imagery from a Building Information Modelling –software to a mobile phone on a construction yard. This was done by producing a Web Service which uses the design software’s Application Programming Interface to interact with a structures model in order to produce the requested imagery. While mobile phones were found lacking as client devices, because of limited processing power and small displays, the implementation showed that the Tekla Structures API can be used to automatically produce various types of imagery. Web Services can be used to transfer this data to the client. Before further development the needs of the contractor, benefits for the building master and inspector and the full potential of the BIM-software need to be mapped out with surveys.

Sulfuric acid - glucose separation using mixed-recycle steady state recycling chromatography

Batch chromatography is a widely used separation technique in a variety of fields meeting difficult separations. Several technologies for improving the performance of chromatography have been studied, including mixed-recycle steady state recycling (MR-SSR) chromatography. Design of MR-SSR has been commonly limited on 100 % purity constraint cases and empirical work. In this study a predictive design method was used to optimize feed pulse size and design a number of experimental MR-SSR separations for a solution of 20 % sulfuric acid and 100 g/L glucose. The design was under target product fraction purities of 98.7 % for H2SO4 and 95 % for glucose. The experiments indicate a maximum of 59 % increase in sulfuric acid productivity and 82 % increase for glucose when compared to corresponding batch separation. Eluent consumption was lowered by approximately 50 % using recycling chromatography. Within this study the target purities and yields set in design were not completely met, and further optimization of the process is deemed necessary.

The strategic use of military contractors : American commercial military service providers in Bosnia and Liberia, 1995-2009

Drawing from strategic theory, this study investigates the strategic roles of commercial companies providing military services, frequently referred to as private military companies. Theoretically, the thesis analyzes how states organize its military capabilities in order to be able to wield power within the international system while empirically, it examines the character and role of commercial companies that provide military training services to the United States Government and partner nations. The reason for this rather instrumental and functional, rather than critical, approach is that this work is written within the discipline known as War Studies. Strategic theory is used first to logically organize the empirical findings in two case studies and then to develop an analytical framework with which the strategic roles of companies providing military services can be investigated. The analysis has been conducted using both new and hitherto unknown sources in the shape of interviews as well as previously classified telegrams, but also draws on previous research and other secondary sources. The main findings are that commercial companies have five typical strategic roles: first, they cloak the state by substituting traditional uniformed troops; second, they act as trailblazers by securing US influence in new regions and by breaking new ground by contributing to the build-up of new partners; third, they act as scene setters by preparing the ground for military exit out of a theater of operations or by facilitating inter-operability between foreign militaries and the US military; fourth, they can be used to infiltrate the security structures of foreign countries; fifth and finally, they can be used to provide offensive capabilities by providing either kinetic or cyber warfare effects. Another finding is that military service contracting is an important part of the US strategic culture.

A design and a prototype for a mobile information service for tourists

Tourism is one of the biggest industry branches with billions of tourists traveling every year around the world. Therefore, solutions providing tourist information have to be up to date with both changes in the industry and the world’s technological progress. The aim of this thesis is to present a design and a prototype of a tourist mobile service which is individual-oriented, cost-free for the end user, and secure. On the information providers’ side, the solution is implemented as a Webbased database. The end users access the information through a Bluetooth application on their mobile devices. The Bluetooth-based solution allows to avoid any costs for the end users, that is tourists. The study shows that, even with small data transfers, the tourists could save significantly when compared to possible roaming charges for data transfer. Also, the proposed mobile service is not intrusive, as it is provided through an application installed by tourists voluntarily on their mobile devices. Through design and implementation this work shows that it is possible to build a system which can be used to provide information services to tourists through mobile phones. The work achieved a successful ongoing synchronization between the client and the server databases. Implementation and usage were limited to smart phones only, as they provide better technological support for the solution having features like maps, GPS, Wi-Fi, Bluetooth and Databases. Moreover, the design of this system shows how Bluetooth technology can be used effectively as a means of communication while minimizing its shortcomings and risks, such as security, by bypassing Bluetooth server service discovery protocol (SDP) and connecting directly to the device. Apart from showing the design and implementation of the end-user costfree mobile information service, the results of this work also highlight the possible business opportunities to the provider of the service.

Evaluation of an indicator for water yield in a watershed of Alto Rio Grande Region, State of Minas Gerais , Brazil

The Brazilian Law stipulates that water is a limited natural resource doted of economic value, thus it is necessary to develop mechanisms for its adequate management. Actions that encourage the farmers to apply soil conservation practices with the purpose of increase water yield from springs and to promote improvement of its quality, reducing production of sediment transportation, is being encouraged by governments, even with financial compensation for owners. From these assertions, this study aims to quantify the benefits of the conservation actions of the management units and to characterize a Water Yield Indicator (WYI) to support sustainable actions in the watershed of Alto Rio Grande region, in the state of Minas Gerais (MG). To assess the impact of actions it were identified four scenarios of land use and occupation of the watershed from Marcela stream which is located in Alto Rio Grande Region. After analyzing the results, it can be stated that the scenarios simulation has demonstrated important changes in water yield and that the definition of the Water Yield Index from the junction of the erosion potential with the water storage potential, has proved effective, as it integrate quantity and quality of water.

The Present State and Future Prospects of a Manpower Pool as Part of Project Business

This research focused on operation of a manpower pool within a service business unit in Company X and aimed to identify how the operation should be improved in order to get most out of it concerning the future prospects of the service business unit. This was done by analyzing the current state of the manpower pool related operations in means of project business, project management and business models. The objective was to deepen the understanding and to highlight possible areas of improvement. The research was conducted as a qualitative single-case study utilizing also an action research method; the research approach was a combination of conceptual, action-oriented and constructive approaches. The primary data was collected with executing a comprehensive literature review and semi-structured theme interviews. The main results described how the manpower pool operates as part of the service business unit in project business by participating in different types of delivery projects; process flows for the project types were mapped. Project management was analyzed especially from the resource management point of view, and an Excel-based skills analysis model was constructed for this purpose. Utilization of operational business models was also studied to define strategic direction for development activities. The results were benchmarked against two competitors in order to specify lessons to be learnt from their use of operational business models.

Quality Indicators of Cervical Cytopathology Tests in the Public Service in Minas Gerais, Brazil

Objective The objective of this study is to assess the performance of cytopathology laboratories providing services to the Brazilian Unified Health System (Sistema Único de Saúde - SUS) in the State of Minas Gerais, Brazil. Methods This descriptive study uses data obtained from the Cervical Cancer Information System from January to December 2012. Three quality indicators were analyzed to assess the quality of cervical cytopathology tests: positivity index, percentage of atypical squamous cells (ASCs) in abnormal tests, and percentage of tests compatiblewith high-grade squamous intraepithelial lesions (HSILs). Laboratories were classified according to their production scale in tests per year≤5,000; from 5,001 to 10,000; from 10,001 to 15,000; and 15,001. Based on the collection of variables and the classification of laboratories according to production scale, we created and analyzed a database using Microsoft Office Excel 97-2003. Results In the Brazilian state of Minas Gerais, 146 laboratories provided services to the SUS in 2012 by performing a total of 1,277,018 cervical cytopathology tests. Half of these laboratories had production scales≤5,000 tests/year and accounted for 13.1% of all tests performed in the entire state; in turn, 13.7% of these laboratories presented production scales of > 15,001 tests/year and accounted for 49.2% of the total of tests performed in the entire state. The positivity indexes of most laboratories providing services to the SUS in 2012, regardless of production scale, were below or well below recommended limits. Of the 20 laboratories that performed more than 15,001 tests per year, only three presented percentages of tests compatible with HSILs above the lower limit recommended by the Brazilian Ministry of Health. Conclusion The majority of laboratories providing services to the SUS in Minas Gerais presented quality indicators outside the range recommended by the Brazilian Ministry of Health.

Suomalaisten osakeyhtiöiden sähköinen tunnistaminen EU:n toimintaympäristössä

Tutkielmassa selvitetään Euroopan Parlamentin sähköisestä tunnistamisesta ja sähköisiin transaktioihin liittyvistä luottamuspalveluista antaman asetusehdotuksen merkitystä sähköisessä tunnistamisessa ja sähköisissä transaktioissa osakeyhtiöiden näkökulmasta yritysten välisessä liiketoiminnassa huomioiden Suomen tämänhetkinen kansallinen lainsäädäntö ja sen kautta omaksutut toimintatavat. Tutkielmassa käytetty pääasiallinen tutkimusmenetelmä on lainoppi. Tutkimusmenetelmänä käytetään myös oikeustaloustieteestä regulaatioteorian normatiivista lähestymistapaa. Tutkielmaa varten on myös haastateltu viranomaisten ja yritysten edustajia. Asetusehdotuksen tavoitteena on edistää rajat ylittävää sähköistä toimintaa. Tätä pyritään lisäämään muun muassa sillä, että jäsenvaltioiden tulee hyväksyä toisessa jäsenvaltiossa käytössä olevia EU:lle ilmoitettuja tunnistusmenetelmiä. Nykyiset direktiivipohjaiseen sääntelyyn perustuvat kansalliset tulkinnat eivät ole johtaneet tavoiteltuun lopputulokseen, joten asetusmuotoinen sääntely on perusteltu. Toimijoina luonnolliset henkilöt ja oikeushenkilöt, kuten osakeyhtiöt, asettavat erilaisia vaatimuksia sähköiselle tunnistamiselle ja sopimusprosessille. Nykymuodossaan asetusehdotus ei sisällöllisesti välttämättä ole taloudellisesti kannattava vaihtoehto yksittäisen EU-valtion kannalta eikä se näin ollen kannusta ilmoittamaan EU:lle tunnistusmenetelmiä eikä yritysten väliseen sähköiseen liiketoimintaan. Tämä johtaa siihen, ettei asetusehdotuksen tavoite välttämättä toteudu.

Hacking User Experience in a Repository Service: ScholarSphere as a Case Study

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

Business-Oriented IT Tool Development For Service Delivery Process

The target of this thesis is to evaluate a bid, project and resource management IT tool for service delivery process via proof-of-concept (POC) project to assess, if the tested software is an appropriate tool for the Case Company’s business requirements. Literature suggests that IT projects implementation is still a grey area in scientific research. Also, IT projects have a notably high rate of failure, one significant reason for this being insufficient planning. To tackle this risk, the Case Company decided to perform a POC project, which involved a hands-on testing period of the assessed system. End users from the business side feel that current, highly tailored project management tool is inflexible, difficult to use, and sets unnecessary limitations for the business. Semi-structured interviews and a survey form are used to collect information about current business practices and business requirements related to the IT tool. For the POC project, a project group involving members from each of the Case Company’s four business divisions was established to perform the hands-on testing. Based on data acquired during the interviews and the hands-on testing period, a target state was defined and a gap analysis was carried out by comparing the features provided by the current tool and the tested tool to the target state, which are, together with the current state description, the most important result of the thesis.

Osaamiskartoitus osaamisen mittaamisen välineenä

Yrityksen aineeton pääoma ja etenkin osaaminen on arvokasta, mutta sen mittaaminen on vaikeaa. Osaaminen on ensin tunnistettava, jotta sitä voidaan kehittää. Tässä tutkimuksessa on tarkoitus luoda kaupan alalle osaamiselle lukuarvo, joka voidaan viedä ketjun tuloskorttiin. Tutkimusaineisto koostuu kuvailevasta ja tilastollisesta osasta. Case yrityksenä on Osuuskauppa Hämeenmaan Sale-ketju ja kartoitus kohdentuu päivittäistavarakaupan myyjän osaamistarpeisiin. Tutkimus toteutettiin kvalitatiivisena tutkimuksena, mutta yhteenvedossa on myös kvantitatiivisia piirteitä. Kuvaileva aineisto koostui ryhmähaastattelusta, joka tehtiin lomakkeen suunnitteluvaiheessa haastattelemalla Osuuskauppa Hämeenmaan Sale-ketjun esimiehiä tulevaisuuden osaamistarpeista. Tilastollinen aineisto koostui osaamistarpeiden kartoituksessa käytetystä kyselystä. Tutkimuksessa tulevaisuuden osaamisen tarve eroaa tutkijoiden esittämästä näkemyksestä ja painottuu asenne osaamiseen. Sale-ketjun asenne osaamisissa vahvuuksia ovat: sitoutuminen omaan työhön ja halu oppia. Ammattiosaamiset kuten hyllytys ja kassatyö ovat myös vahvuuksia. 2013 vuoden tutkimuksessa suurimmat kehitystarpeet olivat tilausjärjestelmien hallitsemisessa sekä kilpailuetuosaamisissa. Yksiköiden välissä tarkastelussa löytyi selkeitä eroja, mutta erot eivät olleet riippuvaisia yksikön koosta tai työryhmän keski-iästä. Tutkimuksen tuloksena jokaiselle yksikölle tuotettiin yhteenveto sen hetkisestä osaamisesta, selvittäen vahvuudet ja kehittämisalueet. Näiden pohjalta tehtiin yksiköille kehityssuunnitelmat sekä jokaiselle työntekijälle henkilökohtainen kehityssuunnitelma kehityskeskustelun yhteydessä. Tämän tutkimuksen mukaan osaaminen, työtyytyväisyys ja asiakastyytyväisyys korreloivat keskenään. Yksikössä, jossa on hyvä osaaminen, ovat myös työtyytyväisyys ja asiakaspalvelu kunnossa. Vaikuttava tekijä taustalla on johtaminen. Esimiehet, jotka jakavat vastuuta työryhmässään saavuttivat osaamisessa suurempaa kehitystä kuin ne esimiehet, jotka eivät vastuuta jakaneet. Päivittäistavarakauppa on murroksessa tällä hetkellä ja tulevaisuuden osaamistarpeet ovat muuttuneet jo tämän tutkimuksen aikana. Vuonna 2014 toteutettiin sama kartoitus kuin vuonna 2013 ja voitiin todeta osaamistarpeen muuttuneen. Kustannustietous ja kriisienhallinta ovat työryhmien arkea ja osaamisalueet kuten työssä jaksaminen, ripeys ja muutosvalmius ovat korostuneet vuoden aikana. Henkilöstöjohtamisen luonteessa on myös havaittavissa muutoksia, kauaskantoinen tekeminen on muuttunut ketteräksi ja joustavaksi strategiseksi kumppanuudeksi. Osaamista johdetaan edelleen hyvin perinteisin menetelmin, johtaminen on vain entistä kohdennetumpaa. Tutkimuksessa syntyi kuvaava malli henkilöstöjohtamisen luonteesta sekä kaupanalan osaamistarpeesta 2014.

Productizing of advanced service for power plants

Työn tavoitteena on kehittää ABB:lle palvelutuote, jota voidaan tarjota voimalaitosasiakkaille. Uuden palvelutuotteen tulee vastata ABB:n uuden strategian linjauksiin. Palvelulla tarjotaan asiakkaille 1.1.2015 voimaan tulleen energiatehokkuuslain määrittelemien pakollisten toimenpiteiden suoritusta. Työssä kerätään, käsitellään ja analysoidaan tietoa voimalaitosasiakkaille suunnatun palvelun tuotteistamisprosessin päätöksenteon tueksi. Palvelutuotteen kehittämistä varten tutkitaan ABB:n nykyisiä palvelutuotteita, osaamista ja referenssi projekteja, energiatehokkuuslakia, voimalaitosten energiatehokkuus-potentiaalia ja erilaisia energiakatselmusmalleja. Päätöksenteon tueksi tehdään referenssiprojektina energia-analyysi voimalaitokselle, jossa voimalaitoksesta tehdään ipsePRO simulointiohjelmalla mallinnus. Mallinnuksen ja koeajojen avulla tutkitaan voimalaitoksen minimikuorman optimointia. Markkinatutkimuksessa selvitetään lainsäädännön vaikutusta, nykyistä markkinatilannetta, potentiaalisia asiakkaita, kilpailijoita ja ABB:n mahdollisuuksia toimia alalla SWOT–analyysin avulla. Tutkimuksen tulosten perusteella tehdään päätös tuotteistaa voimalaitoksille palvelutuote, joka sisältää kaikki toimet energiatehokkuuslain asettamien vaatimusten täyttämiseen yrityksen energiakatselmuksen vastuuhenkilön, energiakatselmuksen ja kohdekatselmuksien teon osalta. Lisäksi työn aikana Energiavirasto myönsi ABB:lle pätevyyden toimia yrityksen energiakatselmuksen vastuuhenkilönä, mikä on edellytyksenä palvelun tarjoamiselle.