Asiakkaan luottamuksen kokemus terveydenhuollon palveluntarjoajaa kohtaan : case tutkimus terveydenhuollon yksityiseltä sektorilta

Tutkimuksen tavoite on selvittää mitkä tekijät vaikuttavat asiakkaan luottamuksen kokemukseen palveluntarjoajaa kohtaan ei kasvokkain tarjottavissa terveyspalveluissa. Tutkimusongelman käsittelyssä kiinnitetään erityisesti huomiota luottamuksen rakentumisen dynamiikkaan ja aikaulottuvuuteen sekä yksityisen palveluntarjoajan maineeseen yhtenä luottamuksen kokemusta selittavänä tekijänä. Kirjailisuuskatsauksessa on määritelty paääkäsitteet maine ja luottamus sekä niiden alakasitteita. Lähteinä on käytetty luottamusta käsittelevää kirjallisuutta useilta eri tieteenaloilta. Case tutkimus on suoritettu laadullisin menetelmin kirjallisuuskatsauksessa esitetyn viitekehyksen ja aikaisemman tutkimuksen pohjalta. Primaariaineisto on kerätty fokusryhmäkeskusteluilia. Aineistoa on pyritty anatysoimaan mahdollisimman yksityiskohtaisesti tutkimuskysymyksen kontekstissa. Analyysin pohjalta tehtyjä tulkintoja on verrattu aikaisempaan tutkimukseen. Case tutkimus osoitti, etta positiivisten odotusten ja suomalaista terveydenhuollon järjestelmää kohtaan tunnetun luottamuksen ansiosta suhtautuminen terveydenhuollon palveluntarjoajaa kohtaan on lähtokohtaisesti luottavainen. Luottamuksen rakentumisen ensivaiheessa nopea luottamus perustuu aikaisemmista kokemuksista siirrettyyn luottamukseen ja stereotypioihin. Seuraavassa vaiheessa luottamus henkilöityy hoitajaan. Luottamus syvenee positiivisten kokemusten ja odotusten täyttymyksen myötä koskemaan myös palveluntarjoajaa. Luottamuksen rakentumisen tärkeimmiksi tekijöiksi nousivat yrityksen maine sosiaalisessa mediassa, suosittelijat, yrityksen asema terveydenhuollon järjestelmässä sekä hoitajien kyvykkyys, kompetenssi, empatiakyky ja potilaan ymmärtäminen.

The adequacy of different robust statistical tests in comparing two independent groups

In the current study, we evaluated various robust statistical methods for comparing two independent groups. Two scenarios for simulation were generated: one of equality and another of population mean differences. In each of the scenarios, 33 experimental conditions were used as a function of sample size, standard deviation and asymmetry. For each condition, 5000 replications per group were generated. The results obtained by this study show an adequate type error I rate but not a high power for the confidence intervals. In general, for the two scenarios studied (mean population differences and not mean population differences) in the different conditions analysed, the Mann-Whitney U-test demonstrated strong performance, and a little worse the t-test of Yuen-Welch.

The communicative dimension of landscape. A theoretical and applied proposal

The fusion of knowledge, the interrelationship of disciplines and, finally, the interaction of learning fields, provides new challenges for an auto denominated global society. The contemporary value of landscape, linked to the patent commodification of culture, the commercial construction of identities, the triumph of inauthenticity, of the induced representation or the economy of symbolism, open up great prospects for studying the symbolic value of landscape. The rapprochement of geographical praxis to the study of space intangibles, linked to the discovery of emotional geographies, besides the growing interest of communicational sciences on the territorial discourse, allow us to envisage a communicative study of landscape based on a fusion of geographical and communicational knowledge. The balancing of the variables: geography, landscape, emotion and communication, enables the progress towards analysing the emotionalisation of space to discern its intangible value, which emerges from the application of different communication techniques.

Aprendizaje y servicio: estudio del grado de satisfacción de estudiantes universitarios

El aprendizaje y servicio es una metodología pedagógica que fomenta el aprendizaje de los estudiantes mediante su participación activa en experiencias asociadas al servicio comunitario. Esta metodología permite al estudiante involucrarse directamente con aquellos a quienes ofrece un servicio, adaptándose a sus necesidades y a una realidad que a menudo es muy diferente de la que vive en el aula. En esto radica uno de sus mayores impactos. Además, este tipo de prácticas contribuye a despertar en los alumnos su interés por la acción colectiva, su formación ciudadana, etc. La investigación que se presenta ha consistido en un estudio diagnóstico- comprensivo con 39 estudiantes, donde a partir del modelo de satisfacción con el que se ha trabajado se han analizado cuatro dimensiones clave (conocimiento e intención atribuida, valoración de la utilidad atribuida, valoración del proceso y proyección social). Estas dimensiones nos han conducido a reflexionar sobre elementos claves del aprendizaje y servicio (aprendizajes ciudadanos, aprendizajes personales, aprendizajes curriculares, procesos de reflexión, etc.). La muestra del estudio ha estado formada por 39 estudiantes y la principal técnica de análisis de la información recogida ha sido el análisis de contenido, mediante la triangulación de técnicas (cuestionario, entrevista y grupos de discusión) e informantes (estudiantes, profesores, coordinadores y miembros de entidades). El análisis de la información muestra un alto grado de satisfacción de los alumnos participantes. La dimensión que ha influido más en este resultado ha sido la valoración de la utilidad atribuida; en concreto, la percepción que tienen los alumnos sobre la adquisición de unos aprendizajes conceptuales, personales y ciudadanos. Atendiendo a lo anterior, cabe señalar que la relación generada entre profesores, entidades y estudiantes, así como la posibilidad de vincular la teoría con la práctica han condicionado los resultados. -------------------------------------------------------------------------------------------- Service learning projects promote student learning through active participation in community service. Thus, the service learning method enables students to engage directly with the people to whom they offer their services and requires them to adapt to other peoples' needs and to a reality that is often very different from the classroom. This is one of the major ways in which service learning has an impact. In addition, service learning helps to awaken students' interest in collective action, citizenship, etc. A comprehensive diagnostic study of 39 students was conducted to analyse four key dimensions (attributed knowledge and intentionality, evaluation of usefulness, evaluation of the process and social impact) on the basis of the chosen satisfaction model. The four dimensions led to reflection on key elements of learning and community service (learning about citizenship, learning about oneself, learning of a curriculum, processes of reflection, etc.). The main data analysis technique was content analysis, involving the triangulation of various techniques (questionnaires, interviews and discussion groups) and informants (students, teachers, coordinators and members of other organisations). Data analysis showed a high degree of satisfaction among the participating students. The dimension that most influenced the results was assessment of the attributed value, more specifically the students' perception of their acquisition of conceptual, personal and citizenship knowledge. It should be cautioned that the results were swayed by the relationship generated among teachers, students and institutions and the possibility of linking theory with practice.

A direct potentiometric titration study of the dissociation of humic acid with selectively blocked functional groups

A direct potentiometric titration method was applied to commercial and soil humic acids in order to determine their carboxyl and phenol group concentrations and apparent and intrinsic pK. In that context, acid-base properties of humic acids are interpreted by selective blocking of carboxylic and phenolic groups by esterification and acetylation. Differences in underivatized and derivatized HA's acid-base properties are ascribed to carboxyl and phenol groups influence on total humic acidity. Potentiometric data were treated with the modified Henderson-Hasselbalch equation. Infra red results, the acidic group contents and the average values of apparent and intrinsic pK for underivatized and derivatized HAs confirmed the selectivity of esterification derivatization method. After blocking of the functional groups, the values of acidic group contents decreased, while the value of apparent pK increased after derivatization. Phenol groups cannot be specifically identified by the acetylation method, due to low selectivity of the acetylation method.

Evaluation of group electronegativities and hardness (softness) of group 14 elements and containing functional groups through density functional theory and correlation with NMR spectra data

Quantum Chemical calculations for group 14 elements of Periodic Table (C, Si, Ge, Sn, Pb) and their functional groups have been carried out using Density Functional Theory (DFT) based reactivity descriptors such as group electronegativities, hardness and softness. DFT calculations were performed for a large series of tetracoordinated Sn compounds of the CH3SnRR'X type, where X is a halogen and R and R' are alkyl, halogenated alkyl, alkoxy, or alkyl thio groups. The results were interpreted in terms of calculated electronegativity and hardness of the SnRR'X groups, applying a methodology previously developed by Geerlings and coworkers (J. Phys. Chem. 1993, 97, 1826). These calculations allowed to see the regularities concerning the influence of the nature of organic groups RR' and inorganic group X on electronegativities and hardness of the SnRR'X groups; in this case, it was found a very good correlation between the electronegativity of the fragment and experimental 119Sn chemical shifts, a property that sensitively reflects the change in the valence electronic structure of molecules. This work was complemented with the study of some compounds of the EX and ER types, where E= C, Si, Ge, Sn and R= CH3, H, which was performed to study the influence that the central atom has on the electronegativity and hardness of molecules, or whether these properties are mainly affected for the type of ligand bound to the central atom. All these calculations were performed using the B3PW91 functional together with the 6-311++G** basis set level for H, C, Si, Ge, F, Cl and Br atoms and the 3-21G for Sn and I atoms.

Choice of Business Process Modeling Methodology - Case Northern Dimension Research Centre (NORDI) in Lappeenranta University of Technology

The main outcome of the master thesis is innovative solution, which can support a choice of business process modeling methodology. Potential users of this tool are people with background in business process modeling and possibilities to collect required information about organization’s business processes. Master thesis states the importance of business process modeling in implementation of strategic goals of organization. It is made by revealing the place of the concept in Business Process Management (BPM) and its particular case Business Process Reengineering (BPR). In order to support the theoretical outcomes of the thesis a case study of Northern Dimension Research Centre (NORDI) in Lappeenranta University of Technology was conducted. On its example several solutions are shown: how to apply business process modeling methodologies in practice; in which way business process models can be useful for BPM and BPR initiatives; how to apply proposed innovative solution for a choice of business process modeling methodology.

Potentiometric quantification and speciation of oxygenated groups in humic substances using BEST7 software

In this study the BEST7 software was employed to quantify different classes of functional groups and to model the proton titration behavior of humic substances. To illustrate the process, the Suwannee River fulvic acid of the IHSS (International Humic Substances Society) was used. Five categories - two classes of phenolic groups (phenol and cathecol), two classes of carboxylic groups (benzoic and phtalic) and the combination between them (salicylic) - of oxygenated groups were considered as being responsible for the potentiometric behavior of the sample and were quantitatively determined. The most and the least abundant groups were cathecol (3.300 ± 0.010 mmol g-1) and phenol (1.225 ± 0.070 mmol g-1), respectively. The estimated equilibrium constants were also determined and were in good agreement with the literature values for phenol and cathecol groups and for benzoic, phtalic and salicylic acids. Distribution diagrams of the species were generated with the software SPE and SPEPLOT.

Considering Target Groups in the Creation of a Comprehensive City Branding Process

The aim of the research was to create a comprehensive city branding process. This was done by identifying the key target groups of the city and considering them in the city branding process. Also key stakeholders were identified and taken into consideration when creating the branding process. As an empirical study, three first stages of the city branding process were implemented for the city of Lappeenranta having "students" as the case target group. An interview with the city officials was conducted, as well as a student survey on the current city image of Lappeenranta. Quantitative research methods were used to analyze the results of the survey. A comprehensive city branding process with eight stages was created in the research. Target groups were considered in the process by identifying the target group dependent stages. The empirical study revealed that the current city image held by the students consists of six dimensions. These dimensions were analyzed from the viewpoint of Lappeenranta with the help of an importance performance analysis.

In pursuit of an intercultural dimension in EFL-teaching : exploring cognitions among Finland-Swedish comprehensive school teachers

This thesis is about the educational purpose of foreign language teaching (FLT) in an increasingly internationalised world.The past 20-30 years have witnessed a fundamental rethinking of the aims of FLT, entailing a shift in emphasis from linguistic competence over communicative competence to intercultural competence. The growing emphasis on cultural issues, called for by research and international curricular documents, places new demandson language teachers. The overall aim of this study is to deepen the knowledge about the attitudes of teachers at the upper level of the Finland-Swedish comprehensive school towards the treatment of culture in English foreign language (EFL) teaching. The questions in focus are: 1) How do teachers interpret the concept"culture" in EFL-teaching?, 2) How do they specify the cultural objectives of their teaching? and 3) What do they do to attain these objectives? The thesis strives to reveal whether or not language teaching today can be describedas intercultural, in the sense that culture is taught with the aim of promotingintercultural understanding, tolerance and empathy. This abductive and largely exploratory study is placed within a constructivist and sociocultural framework,and is inspired by both phenomenography and hermeneutics. It takes its starting-point in language didactics, and can also be regarded as a contribution to teacher cognition research. The empirical data consists of verbatim transcribed interviews with 13 Finland-Swedish teachers of English at grades 7-9. The findings are presented according to three orientations and reviewed with reference to the 2004 Finnish National Framework Curriculum. Within the cognitive orientation, "culture" is perceived as factual knowledge, and the teaching of cultureis defined in terms of the transmission of knowledge, especially about Britain and the USA (Pedagogy of Information). Within the action-related orientation, "culture" is seen as skills of a social and socio-linguistic nature, andthe teaching aims at preparing the students for contacts with people from the target language areas (Pedagogy of Preparation). Within the affective orientation, which takes a more holistic approach, "culture" is seen as a bi-directional perspective. Students are encouraged to look at their own familiar culture from another perspective, and learn to empathise with and show respect for otherness in general, not just concerning representatives of English-speaking countries (Pedagogy of Encounter). Very few of the interviewed teachers represent the third approach, which is the one that can be characterised as truly intercultural. The study indicates that many teachers feel unsure about how to teach culture in an appropriate and up-to-date manner. This is attributed to, among other things, lack of teacher insights as well as lack of time and adequate material. The thesis ends with a set of recommendations as to how EFL could be developed ina more intercultural direction.

Equivalence and translation strategies in multilingual thesaurus construction

In the present dissertation, multilingual thesauri were approached as cultural products and the focus was twofold: On the empirical level the focus was placed on the translatability of certain British-English social science indexing terms into the Finnish language and culture at a concept, a term and an indexing term level. On the theoretical level the focus was placed on the aim of translation and on the concept of equivalence. In accordance with modern communicative and dynamic translation theories the interest was on the human dimension. The study is qualitative. In this study, equivalence was understood in a similar way to how dynamic, functional equivalence is commonly understood in translation studies. Translating was seen as a decision-making process, where a translator often has different kinds of possibilities to choose in order to fulfil the function of the translation. Accordingly, and as a starting point for the construction of the empirical part, the function of the source text was considered to be the same or similar to the function of the target text, that is, a functional thesaurus both in source and target context. Further, the study approached the challenges of multilingual thesaurus construction from the perspectives of semantics and pragmatics. In semantic analysis the focus was on what the words conventionally mean and in pragmatics on the ‘invisible’ meaning - or how we recognise what is meant even when it is not actually said (or written). Languages and ideas expressed by languages are created mainly in accordance with expressional needs of the surrounding culture and thesauri were considered to reflect several subcultures and consequently the discourses which represent them. The research material consisted of different kinds of potential discourses: dictionaries, database records, and thesauri, Finnish versus British social science researches, Finnish versus British indexers, simulated indexing tasks with five articles and Finnish versus British thesaurus constructors. In practice, the professional background of the two last mentioned groups was rather similar. It became even more clear that all the material types had their own characteristics, although naturally not entirely separate from each other. It is further noteworthy that the different types and origins of research material were not used to represent true comparison pairs, and that the aim of triangulation of methods and material was to gain a holistic view. The general research questions were: 1. Can differences be found between Finnish and British discourses regarding family roles as thesaurus terms, and if so, what kinds of differences and which are the implications for multilingual thesaurus construction? 2. What is the pragmatic indexing term equivalence? The first question studied how the same topic (family roles) was represented in different contexts and by different users, and further focused on how the possible differences were handled in multilingual thesaurus construction. The second question was based on findings of the previous one, and answered to the final question as to what kinds of factors should be considered when defining translation equivalence in multilingual thesaurus construction. The study used multiple cases and several data collection and analysis methods aiming at theoretical replication and complementarity. The empirical material and analysis consisted of focused interviews (with Finnish and British social scientists, thesaurus constructors and indexers), simulated indexing tasks with Finnish and British indexers, semantic component analysis of dictionary definitions and translations, coword analysis and datasets retrieved in databases, and discourse analysis of thesauri. As a terminological starting point a topic and case family roles was selected. The results were clear: 1) It was possible to identify different discourses. There also existed subdiscourses. For example within the group of social scientists the orientation to qualitative versus quantitative research had an impact on the way they reacted to the studied words and discourses, and indexers placed more emphasis on the information seekers whereas thesaurus constructors approached the construction problems from a more material based solution. The differences between the different specialist groups i.e. the social scientists, the indexers and the thesaurus constructors were often greater than between the different geo-cultural groups i.e. Finnish versus British. The differences occurred as a result of different translation aims, diverging expectations for multilingual thesauri and variety of practices. For multilingual thesaurus construction this means severe challenges. The clearly ambiguous concept of multilingual thesaurus as well as different construction and translation strategies should be considered more precisely in order to shed light on focus and equivalence types, which are clearly not self-evident. The research also revealed the close connection between the aims of multilingual thesauri and the pragmatic indexing term equivalence. 2) The pragmatic indexing term equivalence is very much context-depended. Although thesaurus term equivalence is defined and standardised in the field of library and information science (LIS), it is not understood in one established way and the current LIS tools are inadequate to provide enough analytical tools for both constructing and studying different kinds of multilingual thesauri as well as their indexing term equivalence. The tools provided in translation science were more practical and theoretical, and especially the division of different meanings of a word provided a useful tool in analysing the pragmatic equivalence, which often differs from the ideal model represented in thesaurus construction literature. The study thus showed that the variety of different discourses should be acknowledged, there is a need for operationalisation of new types of multilingual thesauri, and the factors influencing pragmatic indexing term equivalence should be discussed more precisely than is traditionally done.

Identifying first graders at risk of reading and writing difficulties : creating a group-based screening tool in kiswahili in Tanzania

Early identification of beginning readers at risk of developing reading and writing difficulties plays an important role in the prevention and provision of appropriate intervention. In Tanzania, as in other countries, there are children in schools who are at risk of developing reading and writing difficulties. Many of these children complete school without being identified and without proper and relevant support. The main language in Tanzania is Kiswahili, a transparent language. Contextually relevant, reliable and valid instruments of identification are needed in Tanzanian schools. This study aimed at the construction and validation of a group-based screening instrument in the Kiswahili language for identifying beginning readers at risk of reading and writing difficulties. In studying the function of the test there was special interest in analyzing the explanatory power of certain contextual factors related to the home and school. Halfway through grade one, 337 children from four purposively selected primary schools in Morogoro municipality were screened with a group test consisting of 7 subscales measuring phonological awareness, word and letter knowledge and spelling. A questionnaire about background factors and the home and school environments related to literacy was also used. The schools were chosen based on performance status (i.e. high, good, average and low performing schools) in order to include variation. For validation, 64 children were chosen from the original sample to take an individual test measuring nonsense word reading, word reading, actual text reading, one-minute reading and writing. School marks from grade one and a follow-up test half way through grade two were also used for validation. The correlations between the results from the group test and the three measures used for validation were very high (.83-.95). Content validity of the group test was established by using items drawn from authorized text books for reading in grade one. Construct validity was analyzed through item analysis and principal component analysis. The difficulty level of most items in both the group test and the follow-up test was good. The items also discriminated well. Principal component analysis revealed one powerful latent dimension (initial literacy factor), accounting for 93% of the variance. This implies that it could be possible to use any set of the subtests of the group test for screening and prediction. The K-Means cluster analysis revealed four clusters: at-risk children, strugglers, readers and good readers. The main concern in this study was with the groups of at-risk children (24%) and strugglers (22%), who need the most assistance. The predictive validity of the group test was analyzed by correlating the measures from the two school years and by cross tabulating grade one and grade two clusters. All the correlations were positive and very high, and 94% of the at-risk children in grade two were already identified in the group test in grade one. The explanatory power of some of the home and school factors was very strong. The number of books at home accounted for 38% of the variance in reading and writing ability measured by the group test. Parents´ reading ability and the support children received at home for schoolwork were also influential factors. Among the studied school factors school attendance had the strongest explanatory power, accounting for 21% of the variance in reading and writing ability. Having been in nursery school was also of importance. Based on the findings in the study a short version of the group test was created. It is suggested for use in the screening processes in grade one aiming at identifying children at risk of reading and writing difficulties in the Tanzanian context. Suggestions for further research as well as for actions for improving the literacy skills of Tanzanian children are presented.

Diameter structure of stratum and ecological groups of a Semideciduous Forest area in Dionísio-MG

The objective of this study was to obtain homogeneous groups of species and information on their density, dominance and volume, in terms of ecological group and diameter structure of an area of Submontane Semideciduous forest (Mata do Mumbaça) in Dionísio, MG. This work was conducted with data of the diameter distribution per species from floristic and phytosociological (Mata do Mumbaça) survey of 120 plots with 10 x 10 m each one. The 120 plots were contiguous and corresponding to a total sample area of 12,000 m² distributed over the topographic units (Low Ramp, Lower Slope, Upper Slope and Hill Top). The topographic units Low Ramp, Lower Slope and Upper Slope were in the middle stage of succession as they presented incipient stratification into two strata (canopy and understory) i.e. canopy ranging from 5 to 12 m high. However, the stratum Hill Top was classified as intermediate/advanced succession because it had a total height equal to or greater than 12 m. The distribution of individual trees of the four strata on diameter classes showed a typical J-inverted pattern that is, high concentration of individuals in smaller diameter classes and a sharp reduction towards the larger classes. In relation to absolute dominance and total volume of species, the ecological group that stood out in the four strata (Low Ramp, Lower Slope, Upper Slope and Hill Top) was the initial secondary, which were in the intermediate stage of secondary, rapidly developing into the mature phase.

Induction practices : experiences of newly qualified teachers

The thesis consists of four studies (articles I–IV) and a comprehensive summary. The aim is to deepen understanding and knowledge of newly qualified teachers’ experiences of their induction practices. The research interest thus reflects the ambition to strengthen the research-based platform for support measures. The aim can be specified in the following four sub-areas: to scrutinise NQTs’ experiences of the profession in the transition from education to work (study I), to describe and analyse NQTs’ experiences of their first encounters with school and classroom (study II), to explore NQTs’ experiences of their relationships within the school community (study III), to view NQTs’ experiences of support through peer-group mentoring as part of the wider aim of collaboration and assessment (study IV). The overall theoretical perspective constitutes teachers’ professional development. Induction forms an essential part of this continuum and can primarily be seen as a socialisation process into the profession and the social working environment of schools, as a unique phase of teachers’ development contributing to certain experiences, and as a formal programme designed to support new teachers. These lines of research are initiated in the separate studies (I–IV) and deepened in the theoretical part of the comprehensive summary. In order to appropriately understand induction as a specific practice the lines of research are in the end united and discussed with help of practice theory. More precisely the theory of practice architectures, including semantic space, physical space-time and social space, are used. The methodological approach to integrating the four studies is above all represented by abduction and meta-synthesis. Data has been collected through a questionnaire survey, with mainly open-ended questions, and altogether ten focus group meetings with newly qualified primary school teachers in 2007–2008. The teachers (n=88 in questionnaire, n=17 in focus groups), had between one and three years of teaching experience. Qualitative content analysis and narrative analysis were used when analysing the data. What is then the collected picture of induction or the first years in the profession if scrutinising the results presented in the articles? Four dimensions seem especially to permeate the studies and emerge when they are put together. The first dimension, the relational ˗ emotional, captures the social nature of induction and teacher’s work and the emotional character intimately intertwined. The second dimension, the tensional ˗ mutable, illustrates the intense pace of induction, together with the diffuse and unclear character of a teacher’s job. The third dimension, the instructive ˗ developmental, depicts induction as a unique and intensive phase of learning, maturity and professional development. Finally, the fourth dimension, the reciprocal ˗ professional, stresses the importance of reciprocity and collaboration in induction, both formally and informally. The outlined four dimensions, or integration of results, describing induction from the experiences of new teachers, constitute part of a new synthesis, induction practice. This synthesis was generated from viewing the integrated results through the theoretical lens of practice architecture and the three spaces, semantic space, physical space-time and social space. In this way, a more comprehensive, refined and partially new architecture of teachers’ induction practices are presented and discussed.