Estudi sobre la qualitat de vida de les persones amb demència ateses a la Unitat d'avaluació de deteriorament cognitiu de l'Hospital de la Santa Creu

OBJECTIU: determinar la qualitat de vida de les persones amb demència ateses en una unitat avaluadora de deteriorament cognitiu. MÈTODE: estudi descriptiu transversal amb una mostra consecutiva no probabilística, formada per 42 persones amb demència tipus Alzheimer lleu o moderada i els seus cuidadors. La Qualitat de Vida (QV) es va avaluar amb el qüestionari QoL-AD (Quality of Life Alzheimer’s Disease) en les versions per al pacient (QoL-ADp) i per al cuidador (QoL-ADc). RESULTATS: la mitjana de puntuació del QoL-ADp va ser de 35,38 punts (DE = 5,24) i del QoL-Adc, de 30,60 (DE 5,33). La diferència entre aquests resultats és significativa (p<0,001). Els pacients amb simptomatologia depressiva i els seus cuidadors van puntuar significativament més baix el QoL-AD (p<0,001). En les freqüències per ítems del QoL-ADp s’observa que: més del 75% van valorar com a bona/excel·lent les condicions de vida, família, matrimoni/relació estreta, vida social, situació financera i vida en general; el 61% valoraren bona/excel·lent la capacitat per realitzar tasques a casa; prop del 50% pensava que l’estat d’ànim, l’energia, la salut física, la capacitat per fer coses per diversió i la visió de si mateixos era dolenta/regular, i el 85,7% opinava que la seva memòria era dolenta/regular. CONCLUSIONS: els resultats obtinguts en el QoL-AD no difereixen dels obtinguts en altres investigacions. Suggereixen que les intervencions que genera l’avaluació de la QV en la pràctica clínica inclouen aspectes centrats pròpiament en la malaltia i aspectes vinculats amb les relacions socials.

From "being to the self" to "become to be": on development of autonomy construction in nursing students

Objective: To understand nursing student's self-consciousness and his/her autonomy in the discipline of fundamentals of professional care in the context of a liberating pedagogical proposal. Methodology. This qualitative, case-based research in the model of Ludke and André involved 14 students participating in the discipline. Data were collected by non-participatory observation and analysis of documents. Field observation was conducted from March to July 2010 and data were collected according to the proposal of Minayo: pre-analysis, exploration of material and treatment of results. Results. We constructed two thematic units of analysis: from "being to the self" and exercise of "become to be". Conclusion. When nursing students feel more liberty, they have the opportunity to substitute the scary prospect of learning something new material to something that motivates their curiosity and leads them to become more autonomous.

Teollisuuden palveluliiketoiminnan analysointi ja kehittäminen

Palveluliiketoiminnan merkitys on kasvanut teollisuudessa viime vuosikymmeninä ja sen perusteiden ymmärtäminen sekä liiketoiminnan tilan analysointi on asettanut haasteita yrityksille. Diplomityön tavoitteena oli kehittää työkalu yrityksille teollisuuden palveluliiketoiminnan analysointiin ja kehittämiseen. Asiaa oli käsitelty niukasti aikaisemmin ja näin syntyi tarve tutkimuksen tekemiselle. Työssä painotutaan teollisuuden jälkimyynnin kehittämiseen ja sen perinteisten muotojen erityispiirteiden kuvaamiseen. Lisäksi käsitellään liiketoiminnan kehittämisen osalta niitä asioita, joita tulee ottaa huomioon palveluiden kehittämisessä. Työssä sovelletaan myös roadmap-suunnittelua, joka auttaa yritystä kehittämistoimien organisoinnissa. Työn tuloksena muodostettiin viitekehys, jossa kuvataan teollisuuden palveluliiketoiminnan tasoja ja palveluliiketoiminnan kehittämisen kannalta tärkeitä elementtejä. Lisäksi muodostettiin roadmap-suunnittelun perusteet palveluliiketoiminnalle ja molempia apukeinoja pyrittiin havainnollistamaan teollisuuden yritysesimerkin avulla. Viitekehyksen kehittämisen lopputulos antaa työkalun valmistuskeskeisille yrityksille palveluliiketoiminnan aloittamiseen ja kehittämiseen. Roadmap-suunnittelussa otettiin huomioon palveluiden erityisluonne, jonka johdosta lähestymistapa liiketoiminnan suunnitteluun muuttui.

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.

Dialogue in the crisis of representation : realism and antirealism in the context of the conversation between theologians and quantum physicists in Göttingen 1949-1961

The aim of this study is to analyse the content of the interdisciplinary conversations in Göttingen between 1949 and 1961. The task is to compare models for describing reality presented by quantum physicists and theologians. Descriptions of reality indifferent disciplines are conditioned by the development of the concept of reality in philosophy, physics and theology. Our basic problem is stated in the question: How is it possible for the intramental image to match the external object?Cartesian knowledge presupposes clear and distinct ideas in the mind prior to observation resulting in a true correspondence between the observed object and the cogitative observing subject. The Kantian synthesis between rationalism and empiricism emphasises an extended character of representation. The human mind is not a passive receiver of external information, but is actively construing intramental representations of external reality in the epistemological process. Heidegger's aim was to reach a more primordial mode of understanding reality than what is possible in the Cartesian Subject-Object distinction. In Heidegger's philosophy, ontology as being-in-the-world is prior to knowledge concerning being. Ontology can be grasped only in the totality of being (Dasein), not only as an object of reflection and perception. According to Bohr, quantum mechanics introduces an irreducible loss in representation, which classically understood is a deficiency in knowledge. The conflicting aspects (particle and wave pictures) in our comprehension of physical reality, cannot be completely accommodated into an entire and coherent model of reality. What Bohr rejects is not realism, but the classical Einsteinian version of it. By the use of complementary descriptions, Bohr tries to save a fundamentally realistic position. The fundamental question in Barthian theology is the problem of God as an object of theological discourse. Dialectics is Barth¿s way to express knowledge of God avoiding a speculative theology and a human-centred religious self-consciousness. In Barthian theology, the human capacity for knowledge, independently of revelation, is insufficient to comprehend the being of God. Our knowledge of God is real knowledge in revelation and our words are made to correspond with the divine reality in an analogy of faith. The point of the Bultmannian demythologising programme was to claim the real existence of God beyond our faculties. We cannot simply define God as a human ideal of existence or a focus of values. The theological programme of Bultmann emphasised the notion that we can talk meaningfully of God only insofar as we have existential experience of his intervention. Common to all these twentieth century philosophical, physical and theological positions, is a form of anti-Cartesianism. Consequently, in regard to their epistemology, they can be labelled antirealist. This common insight also made it possible to find a common meeting point between the different disciplines. In this study, the different standpoints from all three areas and the conversations in Göttingen are analysed in the frameworkof realism/antirealism. One of the first tasks in the Göttingen conversations was to analyse the nature of the likeness between the complementary structures inquantum physics introduced by Niels Bohr and the dialectical forms in the Barthian doctrine of God. The reaction against epistemological Cartesianism, metaphysics of substance and deterministic description of reality was the common point of departure for theologians and physicists in the Göttingen discussions. In his complementarity, Bohr anticipated the crossing of traditional epistemic boundaries and the generalisation of epistemological strategies by introducing interpretative procedures across various disciplines.

Vertaileva tapaustutkimus kuusivuotiaiden opetus–oppimis -vuorovaikutuksesta, matematiikkaepisodeista ja lukukäsitteen osaamisesta

Tässä vertailevassa kansainvälisessä tapaustutkimuksessa tarkasteltiin kuusivuotiaiden matematiikan tuntien opetus–oppimis -vuorovaikutusta ja lukukäsitteen osaamista Suomen, Englannin ja Ruotsin toiminta- ja oppimisympäristöissä. Toteutuneita opetus–oppimis -prosesseja verrattiin opetussuunnitelmien yleisiin- ja matematiikan tavoitteisiin sekä lukukäsitteen osaamistasoon. Empiirinen tutkimusaineisto sisälsi lasten (N=99) lukukäsitteen osaamistason yksilötestauksen ja laadullisen analyysin yhteensä seitsemän viikon matematiikan tuntien (880 minuutin) videoidusta opetus – oppimis -vuorovaikutuksesta. Minuutin analyysiyksikköina tarkasteltuna kuusivuotiaiden tutkimusviikon matematiikan tuntien opetus–oppimis -vuorovaikutuksesta lähes puolet ilmensi opettajalähtöisyyttä, kolmannes oppijalähtöisyyttä ja lähes viidennes ilmensi jaettua vuorovaikutusta. Kun tutkimusviikon matematiikan opetusta tarkasteltiin merkityksellisten vuorovaikutuskokonaisuuksien, episodien luokittelun pohjalta havaittiin, että kaikista viikon matematiikkaepisodeista (N=371) yli puolet edusti opettajalähtöisyyttä ja kolmannes edusti opettajalähtöisen ja jaetun vuorovaikutuksen yhdistelmää. Episodien keskimääräinen kesto oli noin kaksi minuuttia tässä tutkimuksessa. Tuloksissa ilmeni ryhmien välisiä eroja opetus–oppimis -vuorovaikutuksen ominaisuuksissa sekä erityyppisiä matematiikan tuntien rakennemalleja ja lukukäsitteen osaamistasoeroja. Monipuolinen ja muita näytteitä enemmän jaettua vuorovaikutusta edustava oppimisympäristö, oli tässä aineistossa yhteydessä keskiarvoa korkeampaan lukukäsitteen osaamistasoon. Korostetun opettajalähtöinen oppimisympäristö oli yhteydessä keskimääräiseen lukukäsitteen osaamistasoon. Muita tutkimuskohteita oppijalähtöisempi oppimisympäristö oli yhteydessä keskimääräisistä alempaan lukukäsitteen osaamistasoon. Tutkimustulosten perusteella tarkentuu kuva erilaisista opetus–oppimis -prosessin osatekijöistä, joita voidaan mahdollisesti soveltaa eri oppiaineisiin vastaavanlaisissa formaaleissa oppimisympäristöissä.

Conceptions of mathematics teacher education : thoughts among teacher educators in Tanzania

This study addresses the question of teacher educators’ conceptions of mathematics teacher education (MTE) in teacher colleges in Tanzania, and their thoughts on how to further develop it. The tension between exponents of content as opposed to pedagogy has continued to cause challenging conceptual differences, which also influences what teacher educators conceive as desirable in the development of this domain. This tension is connected to the dissatisfaction of parents and teachers with the failure of school mathematics. From this point of view, the overall aim was to identify and describe teacher educators’ various conceptions of MTE. Inspired by the debate among teacher educators about what the balance should be between subject matter and pedagogical knowledge, it was important to look at the theoretical faces of MTE. The theoretical background involved the review of what is visible in MTE, what is yet to be known and the challenges within the practice. This task revealed meanings, perspectives in MTE, professional development and assessment. To do this, two questions were asked, to which no clear solutions satisfactorily existed. The questions to guide the investigation were, firstly, what are teacher educators’ conceptions of MTE, and secondly, what are teacher educators’ thoughts on the development of MTE? The two questions led to the choice of phenomenography as the methodological approach. Against the guiding questions, 27 mathematics teacher educators were interviewed in relation to the first question, while 32 responded to an open-ended questionnaire regarding question two. The interview statements as well as the questionnaire responses were coded and analysed (classified). The process of classification generated patterns of qualitatively different ways of seeing MTE. The results indicate that MTE is conceived as a process of learning through investigation, fostering inspiration, an approach to learning with an emphasis on problem solving, and a focus on pedagogical knowledge and skills in the process of teaching and learning. In addition, the teaching and learning of mathematics is seen as subject didactics with a focus on subject matter and as an organized integration of subject matter, pedagogical knowledge and some school practice; and also as academic content knowledge in which assessment is inherent. The respondents also saw the need to build learner-educator relationships. Finally, they emphasized taking advantage of teacher educators’ neighbourhood learning groups, networking and collaboration as sustainable knowledge and skills sharing strategies in professional development. Regarding desirable development, teacher educators’ thoughts emphasised enhancing pedagogical knowledge and subject matter, and to be determined by them as opposed to conventional top-down seminars and workshops. This study has revealed various conceptions and thoughts about MTE based on teacher educators´ diverse history of professional development in mathematics. It has been reasonably substantiated that some teacher educators teach school mathematics in the name of MTE, hardly distinguishing between the role and purpose of the two in developing a mathematics teacher. What teacher educators conceive as MTE and what they do regarding the education of teachers of mathematics revealed variations in terms of seeing the phenomenon of interest. Within limits, desirable thoughts shed light on solutions to phobias, and in the same way low self-esteem and stigmatization call for the building of teacher educator-student teacher relationships.

Kokemusperäisen tiedon jakaminen työkierrossa

Kokemusperäinen tieto on käytäntöihin sitoutunutta ja siirtyy pitkälti vuorovaikutuksen kautta. Organisaation toiminnalle keskeisenä osatekijänä sen jakamisen tulee olla suunnitelmallista. Tämä tutkimus keskittyy tarkastelemaan kokemusperäisen tiedon jakamista työkierron avulla. Työkierto osaamisen kehittämisen menetelmänä on laajalti organisaatioiden käyttämä, mutta sen tutkiminen kokemusperäisen tiedon osalta on ollut vähäistä. Tutkimuksen teoriaosuus tarkastelee tiedon jakamista ja omaksumista yksilön ja organisaation tasoilla hyödyntäen tietoperustaisen näkemyksen ja organisaation oppimisen teorioita, joiden kautta tutkimuksen viitekehys muotoutui. Tutkimuksen empiriaosuus toteutettiin kvalitatiivisina teemahaastatteluina, joissa haastateltiin kuutta työkierron mentori-oppija –paria. Tutkimuksen tulokset osoittivat työkierron olevan toimiva keino siirtää kokemusperäistä tietoa, johon merkittävimpinä keinoina vaikuttivat vuorovaikutuksellinen yhdessä työskenteleminen, sekä toiminnan organisoinnin suunnitelmallisuus. Tutkimuksen johtopäätöksenä esitettiin yhdenmukaisen työkierron suunnitelman rakentamista, sekä työkierron toteutumisen sitouttamista osaksi työn arviointia.

Integration of learning supportive applications into the development of the e-portfolio construction process

The portfolio as a means of demonstrating personal skills has lately been gaining prominence among technology students. This is partially due to the introduction of electronic portfolios, or e-portfolios. As platforms for e-portfolio management with different approaches have been introduced, the learning cycle, traditional portfolio pedagogy, and learner centricity have sometimes been forgotten, and as a result, the tools have been used for the most part as data depositories. The purpose of this thesis is to show how the construction of e-portfolios of IT students can be supported by institutions through the usage of different tools that relate to study advising, teaching, and learning. The construction process is presented as a cycle based on learning theories. Actions related to the various phases of the e-portfolio construction process are supported by the implementation of software applications. To maximize learner-centricity and minimize the intervention of the institution, the evaluated and controlled actions for these practices can be separated from the e-portfolios, leaving the construction of the e-portfolio to students. The main contributions of this thesis are the implemented applications, which can be considered to support the e-portfolio construction by assisting in planning, organizing, and reflecting activities. Eventually, this supports the students in their construction of better and more extensive e-portfolios. The implemented tools include 1) JobSkillSearcher to help students’ recognition of the demands of the ICT industry regarding skills, 2) WebTUTOR to support students’ personal study planning, 3) Learning Styles to determine students' learning styles, and 4) MyPeerReview to provide a platform on which to carry out anonymous peer review processes in courses. The most visible outcome concerning the e-portfolio is its representation, meaning that one can use it to demonstrate personal achievements at the time of seeking a job and gaining employment. Testing the tools and the selected open-source e-portfolio application indicates that the degree of richness of e-portfolio content can be increased by using the implemented applications.

Luottamuksen lähteet. Vertaileva tutkimus yleistynyttä luottamusta synnyttävistä mekanismeista

Tutkimuksen aiheena on yleistynyt luottamus. Väitöskirjassa tutkitaan mistä tuntemattomien kansalaisten toisiinsa kohdistama luottamus kumpuaa ja haetaan vastauksia tähän kysymykseen sekä maakohtaisen että vertailevan tutkimuksen avulla. Tutkimus koostuu yhteenvedon lisäksi viidestä tutkimusartikkelista, joissa luottamuksen syntyä tarkastellaan sekä yksilöiden mikrotason vuorovaikutuksen että maiden välisten eroavaisuuksien näkökulmasta. Yleistyneen luottamuksen synnystä on esitetty useita eri teorioita. Tässä tutkimuksessa tarkastellaan näistä kahta keskeisintä. Osa tutkijoista korostaa kansalaisyhteiskunnan ja ruohonjuuritason verkostojen roolia yleistyneen luottamuksen synnyn taustalla. Tämän hypoteesin mukaan kansalaiset, jotka viettävät aikaansa yhdistyksissä tai muissa sosiaalisissa verkostoissa, oppivat muita helpommin luottamaan paitsi täysin tuntemattomiin ihmisiin myös yhteiskunnallisiin instituutioihin (kansalaisyhteiskuntakeskeinen hypoteesi). Toiset taas painottavat yhteiskunnan julkisten instituutioiden merkitystä. Tämä hypoteesi korostaa instituutioiden reiluutta ja oikeudenmukaisuutta (instituutiokeskeinen hypoteesi). Ihmiset pystyvät luottamaan toisiinsa ja ratkaisemaan kollektiivisia ongelmiaan yhdessä silloin kun esimerkiksi poliittiset ja lainsäädännölliset instituutiot pystyvät luomaan tähän tarvittavan toimintaympäristön. Aineistoina käytetään kansallisia (Hyvinvointi- ja palvelut) sekä kansainvälisiä vertailevia kyselytutkimuksia (European Social Survey ja ISSP). Yksilö- ja makrotason analyyseja yhdistämällä selvitetään yleistynyttä luottamusta selittäviä tekijöitä sekä mekanismeja joiden kautta yleistynyt luottamus muodostuu. Väitöskirjan tulokset tukevat suurimmaksi osaksi instituutiokeskeiseen suuntaukseen sisältyviä hypoteeseja yleistyneen luottamuksen kasautumisesta. Kuitenkin myös esimerkiksi yhdistystoiminnalla havaittiin olevan joitakin yhdistysjäsenien ulkopuolelle ulottuvia myönteisiä vaikutuksia kansalaisten luottamukseen, mikä taas tukee kansalaisyhteiskuntakeskeistä hypoteesia. Tutkimuksen keskeinen tulos on, että kaiken kaikkiaan luottamus näyttäisi kukoistavan maissa, joissa kansalaiset kokevat julkiset instituutiot oikeudenmukaisina sekä reiluina, kansalaisyhteiskunnan roolin luottamuksen synnyttämisessä ollessa tälle alisteinen. Syyksi tähän on oletettu, että näissä maissa (erityisesti pohjoismaiset hyvinvointivaltiot) harjoitettu universaali hyvinvointipolitiikka ja palvelut ovat keskeisiä korkeaa yleistynyttä luottamusta selittäviä tekijöitä. Toisaalta maavertailuissa tätä yhteyttä on selitetty myös sillä, että näissä yhteiskunnassa ei ole paikannettavissa selkeää kulttuurisesti erottuvaa alaluokkaa. Tämän tutkimuksen tulokset tukevat enemmän universaalin hyvinvointivaltion oikeudenmukaisuuteen liittyviä ominaisuuksia alaluokkaistumishypoteesin sijaan. Toisaalta mikrotasolla tarkasteltuna yleistyneen luottamuksen ja hyvinvointipalvelujen välinen yhteys liittyy enemmän palveluiden riittävyyteen kuin niiden universaalisuuden asteeseen. Niin ikään maavertailuissa esimerkiksi verotuksen oikeudenmukaisena kokeminen näyttäisi olevan palvelujen saatavuutta tai niihin liittyviä oikeudenmukaisuuden kokemuksia tärkeämpi seikka yleistyneen luottamuksen kannalta.

The good and the successful - Examination of informal learning mechanisms

This thesis strived to find out which informal learning (IL) mechanisms are used the most by the respondents. Additionally, the goal was to know more about the respondents as informal learners and what could explain possible differences. The target was to resolve whether informal learning explains differences in individual performance or, do some other explanations for success exist. Informal learning was to be made more visible, since many are unaware of it. Relevant IL mechanisms that the interviewees could explain were selected for this thesis. The theory on informal learning was presented and some additional informal learning mechanisms were included: Underlying learning theories, internal and external learning resources, as well as some sport related informal learning mechanisms. Various scholars have explained these terms. The final results of this thesis relate to business context, but sport is at the scope of my research. The target group consisted of nine individuals in team sports that were considered as high performers (good/successful). Hence, also the concept of high performance was clarified with competence, expertise and talent literature. The study is qualitative and face-to-face interviews were chosen. The data was analyzed with Grounded Theory principles and theory elaboration. This thesis pointed out similarities and differences between the respondents´ answers (good/successful, inexperienced/experienced). Thus, the analysis clarified that there are different attitudes to learning and different learner profiles in sports context. Also, it became clear that some informal learning mechanisms are more used than others. Secondly, based on the most crucial differences, Typology of Talentum was formulated based on Le Deist & Winteron´s (2005, 39) Typology of holistic competence. Some variables of informal learning seemed to constitute the Meta-competence of Typology that ultimately causes the differences in individual performance and success. The results can be transferred to business context because meta-competence is transferable by nature.

Limits of Meritocracy. How Fields of Study and Gender Segregation Affect Social Stratification in Finland

This dissertation critically reviews the idea of meritocracy from both a theoretical and an empirical perspective. Based on a discussion of classical texts of social philosophy and sociology, it is argued that meritocracy as a concept for social stratification is best compatible with the sociological tradition of status attainment research: both frame social inequality in primarily individualistic terms, centring on the role of ascribed (e.g., gender, social background) and achieved (e.g., educational qualifications) characteristics for determining individuals’ socioeconomic rewards. This theoretical argument introduces the research problem at the core of this dissertation: to what extent can the individualistic conception of social stratification be maintained empirically? Fields of study and their interaction with educational attainment levels play a prominent role in the analysis of this question. Drawing on sociological versions of segmented labour market theory, it is assumed that fields of study may channel individuals into heterogeneous political-economic contexts on the labour market, which potentially modify the socioeconomic benefit individuals derive from their qualification levels. The focus on fields of study may also highlight economic differentials between men and women that derive from the persisting segregation of men’s and women’s occupational and educational specializations rather than direct gender discrimination on the labour market. The quantitative analyses in this dissertation consist of three research articles, which are based primarily on Finnish data, but occasionally extend the view to other European countries. The data sources include register-based macro- and microdata as well as survey data. Article I examines the extent and the patterns of gender segregation within the Finnish educational system between 1981 and 2005. The results show that differences between men’s and women’s field specializations have for the most part remained stable during this period, with particularly high levels of gender segregation observed at lower educational levels. The focus in Article II rests on the effects of gender-segregated fields of study on higher education graduates’ occupational status. It is shown that fields of study matter for accessing professional jobs and avoiding low-skilled positions in Finland: at the early career stage, particularly polytechnic graduates from female-dominated fields are less likely to work in professional positions. Finnish university graduates from male-dominated fields were more likely than their peers with different specializations to work as professionals, yet they also faced a greater risk of being sorted into lowskilled jobs if they failed to make use of this advantage. Article III proceeded to analyse the joint impact of educational qualification levels and fields of study on young adults’ median earnings in Finland between 1985 and 2005. The results show that qualification levels do not confer a consistent benefit in the process of earnings stratification. Advanced qualifications raise median earnings most clearly among individuals specializing in the same field of study. When comparing individuals with different field specializations, on the other hand, higher-level qualifications do not necessarily lead to higher median earnings. Overall, the findings of this dissertation reveal a heterogeneous effect of education for achieving social positions, which challenges individual-centred, meritocratic accounts of social stratification and underlines the problematic lack of structural and institutional dimensions in the dominant account of social status attainment.

Facing the Hydra alone: three case studies

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

Solar Twins and Solar Analogues in Galactic Surveys.

The Sun is a crucial benchmark for how we see the universe. Especially when it comes to the visible range of the spectrum, stars are commonly compared to the Sun, as it is the most thoroughly studied star. In this work I have focussed on two aspects of the Sun and how it is used in modern astronomy. Firstly, I try to answer the question on how similar to the Sun another star can be. Given the limits of observations, we call a solar twin a star that has the same observed parameters as the Sun within its errors. These stars can be used as stand-in suns when doing observations, as normal night-time telescopes are not built to be pointed at the Sun. There have been many searches for these twins and every one of them provided not only information on how close to the Sun another star can be, but also helped us to understand the Sun itself. In my work I have selected _ 300 stars that are both photometrically and spectroscopically close to the Sun and found 22 solar twins, of which 17 were previously unknown and can therefore help the emerging picture on solar twins. In my second research project I have used my full sample of 300 solar analogue stars to check the temperature and metallicity scale of stellar catalogue calibrations. My photometric sample was originally drawn from the Geneva-Copenhagen-Survey (Nordström et al. 2004; Holmberg et al. 2007, 2009) for which two alternative calibrations exist, i.e. GCS-III (Holmberg et al. 2009) and C11 (Casagrande et al. 2011). I used very high resolution spectra of solar analogues, and a new approach to test the two calibrations. I found a zero–point shift of order of +75 K and +0.10 dex in effective temperature and metallicity, respectively, in the GCS-III and therefore favour the C11 calibration, which found similar offsets. I then performed a spectroscopic analysis of the stars to derive effective temperatures and metallicities, and tested that they are well centred around the solar values.

Quality of radiotherapy care by development of e-feedback knowledge

The aim of this three phase study was to develop quality of radiotherapy care by the e-Feedback knowledge of radiotherapy -intervention (e-Re-Know). In Phase I, the purpose was to describe the quality of radiotherapy care and its deficits experienced by cancer patients. Based on the deficits in patient education in Phase II, the purpose was to describe cancer patients’ e-knowledge expectations in radiotherapy. In Phase III, the purpose was to develop and evaluate the outcomes of the e-Re-Know among breast cancer patients. The ultimate aim was to develop radiotherapy care to support patients’ empowerment with patient e-education. In Phase I (2004-2005), the descriptive design was used, and 134 radiotherapy patients evaluated their experiences by Good Nursing Care Scale for Patients (GNCS-P) in the middle of RT period. In Phase II (2006-2008), the descriptive longitudinal design was used and 100 radiotherapy patients’ e-knowledge expectations of RT were evaluated using open-ended questionnaire developed for this study before commencing first RT, in the middle of the treatment, and concluding RT period. In Phase III, firstly (2009-2010), the e-Re-Know intervention, i.e. knowledge test and feedback, was developed in terms of empowering knowledge and implemented with e-feedback approach based on literature and expert reviews. Secondly (2011-2014), the randomized controlled study was used to evaluate the e-Re-Know. Breast cancer patients randomized to either the intervention group (n=65) receiving the e-Re-Know by e-mail before commencing first RT and standard education or the control group (n=63) receiving standard education. The data were collected before commencing first RT, concluding last RT and 3 months after last RT using RT Knowledge Test, Spielberger’s State Trait Inventory (STAI) and Functional Assessment of Cancer Therapy - Breast (FACT-B) –instruments. Data were analyzed using statistical methods and content analysis. The study showed radiotherapy patients experienced quality of care high. However, there were deficits in patient education. Furthermore, radiotherapy patients’ multidimensional e-knowledge expectations through Internet covered mainly bio-physiological and functional knowledge. Thus, the e-Re-Know was developed and evaluated. The study showed when breast cancer patients’ carried out the e-Re-Know their knowledge of side effects self-care was significantly increased and quality of life (QOL) significantly improved in line with decrease in anxiety from time before radiotherapy period to three months after. In addition, the e-Re-Know has potential to have positive effects on anxiety and QOL, regardless of patient characteristics or knowledge level. The results support the theory of empowering patient education suggesting that empowerment can be supported by confirming patients’ understanding of own knowledge level. In summary, the e-Feedback knowledge of radiotherapy (e-Re-Know) intervention can be recommended in development of quality of radiotherapy care experienced by breast cancer patients. Further research is needed to assess and develop patient-centred quality of care by patient education among cancer patients.