Datenherrschaft – an Ethically Justified Solution to the Problem of Ownership of Patient Information

Patient information systems are crucial components for the modern healthcare and medicine. It is obvious that without them the healthcare cannot function properly – one can try to imagine how brain surgery could be done without using information systems to gather and show information needed for an operation. Thus, it can be stated that digital information is irremovable part of modern healthcare. However, the legal ownership of patient information lacks a coherent and justified basis. The whole issue itself is actually bypassed by controlling pa- tient information with different laws and regulations how patient information can be used and by whom. Nonetheless, the issue itself – who owns the patient in- formation – is commonly missed or bypassed. This dissertation show the problems if the legislation of patient information ownership is not clear. Without clear legislation, the outcome can be unexpected like it seems to be in Finland, Sweden and United Kingdom: the lack of clear regulation has come up with unwanted consequences because of problematic Eu- ropean Union database directive implementation in those countries. The legal ownership is actually granted to the creators of databases which contains the pa- tient information, and this is not a desirable situation. In healthcare and medicine, we are dealing with issues such as life, health and information which are very sensitive and in many cases very personal. Thus, this dissertation leans on four philosophical theories form Locke, Kant, Heidegger and Rawls to have an ethically justified basis for regulating the patient infor- mation in a proper way. Because of the problems of property and ownership in the context of information, a new concept is needed and presented to replace the concept of owning, that concept being Datenherrschaft (eng. mastery over in- formation). Datenherrschaft seems to be suitable for regulating patient infor- mation because its core is the protection of one’s right over information and this aligns with the work of the philosophers whose theories are used in the work. The philosophical argumentation of this study shows that Datenherrschaft granted to the patients is ethically acceptable. It supports the view that patient should be controlling the patient information about themselves unless there are such specific circumstance that justifies the authorities to use patient information to protect other people’s basic rights. Thus, if the patients would be legally grant- ed Datenherrschaft over patient information we would endorse patients as indi- viduals who have their own and personal experience of their own life and have a strong stance against any unjustified paternalism in healthcare. Keywords: patient information, ownership, Datenherrschaft, ethics, Locke, Kant, Heidegger, Rawls

Breastfeeding preterm infant from the delivery ward via nicu to home

The aim of this study was to examine how to support breastfeeding of preterm infants immediately after birth in the delivery ward, during their hospital stay in a neonatal intensive care unit (NICU), and at home after hospital discharge. Specifically, the role of early physical contact, maternal breastfeeding attitude, and an internet-based peer support group were investigated. The delivery ward practices concerning the implementation of early physical contact between a mother and her infant admitted to a NICU were examined by a structured survey in two hospitals. An Internet-based, breastfeeding peer-support intervention for the mothers of preterm infants was developed and tested in a randomized controlled design with one year follow-up. The main outcomes were the duration of exclusive and overall breastfeeding, expressing milk, and maternal attitude. In addition, the perceptions of mothers of preterm infants were investigated by analyzing the peer-support group discussions with a qualitative approach. The implementation of early physical contact was different between the two hospitals studied and was based more on hospital routines than the physiological condition of the infant. Preterm infants, who were born before a gestational age (GA) of 32 weeks, were hardly ever allowed to have early contact with their mothers. Both, a higher GA and early physical contact predicted earlier initiation and increased frequency of breastfeeding in the NICU. A maternal breastfeeding-favorable attitude predicted increased frequency of breastfeeding in the NICU and also a longer duration of overall breastfeeding. The actual duration of breastfeeding was, however, shorter than the mothers intended in advance. The internet-based, peer-support intervention had no effect on the duration of breastfeeding, expressing milk, or maternal attitude. The participating mothers enjoyed the possibility of sharing their experiences of preterm infants with other mothers in similar situations. Some of the mothers also experienced being given useful advice for breastfeeding. Based on the mothers’ discussions, a process of breastfeeding preterm infants was created. This included some paradoxical elements in the NICU where, for example, breast milk was emphasized over breastfeeding and support in the hospital varied. Hospital discharge was a critical point, when the mothers faced breastfeeding in reality. Over time, the mothers assimilated their breastfeeding experience into part of being a mother. The care practices related to early physical contact in delivery wards need to be re-evaluated to allow more infants to have a moment with the mother. Maternal attitude could be screened prenatally and attitude-focused interventions developed. Breastfeeding support in the NICU should be standardized. Internet-based breastfeeding peer-support intervention was feasible but additional research is needed.

Home Made Cars: An insight on Consumer Ethnocentrism – Case Saab

Saab outstands in the history of the Finnish car manufacturing. This is not only due to that these cars have been manufactured in Finland more than other passenger vehicles altogether. Finns also have a special emotional attachment to the “Finnish Saabs”. Findings from previous studies show that consumers connect cars well to the origin of the brand (COB). They are however rarely aware of the Country of Manufacturing (COM). Domestic brands are often popular in the COB, but research from situations in which the domestic origin is limited to the COM is rare. The case of this study is a phenomenon, in which the products origin is two dimensional and divided into domestic COM and foreign COB. The aim is to understand the phenomenon’s effect on consumer behavior. The research problem is approached with two sub questions: • Which country do consumers perceive as the origin country of the car? • What is the role of this origin in the consumers’ product perception and purchasing decision of the car? The theoretical framework of this study applies previous findings of two areas of interest: Country of Origin effect and Consumer Ethnocentrism. This is followed by feasibility studies that present and discuss the history and current state of Finnish car manufacturing. Based on the findings of earlier stages of the study, the role of the domestic COM on consumer behavior is presumed high. This expectation is confirmed by the experts and also by the first consumer respondent, who states domestic origin having been the main motivation to his car choice. All further consumer respondents do however not connect Saab to the home country, but discuss it as a Nordic car. This unexpected finding means that they do not perceive the origin to be neither the COM nor COB, but a geographical area that includes both countries. In other words, consumers have widened their in-group in a way that is in this thesis explained with reference group theory. The consumers’ perceived origin of the car is in this research found to be an important factor to the consumers’ product perception and purchasing decision. Being fit for the yields of the local environment is discovered to have been the most important factor to Finnish consumers purchasing choice of a Saab and the Nordic origin has been an indicator of this fit to them.

Brigadier-général [Dayrell Talbot] Hammond, un des membres influents de la ligue Home Rule arrive à la conférence de Dublin : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 60754

Home schooling in view of John Calvin : a study in education and communion of saints /

This study explores the tension that has emerged around the rise of home schooling in a faith-community strongly committed to establishing and maintaining day schools in the tradition of John Calvin. It aims to identify and understand factors that contributed to this tension and to find ways to bridge, diffuse, reduce, or eliminate it. In line with Calvin, personal convictions, and the nature of the community, the study takes a Christian epistemological and axiological stance. Its premise is that the integrity of the commvmity is more important than the manner in which its children are taught. The study reviews relevant literature and several interviews. It considers both secular and Christian literature to understand communities, community breakdown, and community restoration. It also examines literature about the significance of home, school, and community relationships; the attraction of Reformed day schools; and the appeal of home schooling. Interviews were conducted with 4 home schooling couples and 2 focus groups. One focus group included local school representatives, and the other home schoolers and school representatives from an area with reputedly less tension on the issue. Interviews were designed for participants to give their perspectives on reasons for home schooling, the existing tension, and ways to resolve the issues. The study identifies the rise of home schooling in this particular context as the initial issue and the community's deficiency to properly deal with it as the chief cause for the rising tensions. However, I argue that, within the norms the community firmly believes in, home schooling need not jeopardize its integrity. I call for personal, social, and spiritual renewal to restore the covenant community in gratitude to God.

Heroes on the home front : heroism and virtue in post-9/11 American cinema /

This thesis is intended to contribute to critical discussion of the American male hero in mainstream American war and action films post September 11, 2001 . The thesis investigates how these heroes' behaviour echoes a patriotic, conservative construction of the modern American as created through speeches given by George W. Bush in the wake of the events of September 11, 2001 . The thesis examines the hero in six primary sources: the war films We Were Soldiers, Behind Enemy Lines and The Great Raid and the action films Collateral Damage, Man on Fire and The Punisher. By analyzing the ideological subtext, political content, visual strategies and generic implications of the films, as well as the binary constructions of a selection of Bush speeches, and by reviewing historical representations of American male heroes on film produced in the wake of political events, the thesis concludes that the six films mobilize the USA's conservative viewpoint towards war and military action, and in concert with the speeches, contribute to an ongoing militarization of visual culture. Both systems echo a dangerous ideological fantasy of American history, life and patriotism.

The effects of day care at the kindergarten level : day care centre versus in-home care

Two groups of nonmaternal day care providers, one made up of in-horne caregivers, and the other of providers of day care in centres, were asked to focus on their goals for the children in their care. A group of kindergarten teachers was asked to consider any differences they noticed in children in· the two types of day care mentioned above. It was found that in-horne caregivers, through flexibility, meet the developmental goals of the children in their care. Providers of tlay care in centres used a more structured and social program in order to meet the overall developmental goals for the children in their care. It was found that the kindergarten teachers noticed differences in the children in their classes in terms of their attitude and social behaviour. The type and quality of care were seen as possible influences on this outlook of young children in kindergarten. The one common element that each group highlighted with respect to the effects of day care at the kindergarten level was the important role of the family in the child's development not only in day care, but also in kindergarten class. There is still a strong need to determine the effects of various types of day care at all levels, and specifically at the kindergarten level. The more the kindergarten teacher is able to understand about the child's day care experience, and his or her own life,the better off these children in day care will be. This study confirmed both the importance of quality in child care, and the important role of the family in the child care decision.

Chapman family home, Fullerton, California, 1908

Chapman family residence, Fullerton, California, ca. 1908. Mounted on heavy weight card stock with small calendar for 1908. "Miss Ethel Chapman" written in ink on top of calendar.

Garden party at Charles C. Chapman's home, Fullerton, California, 1914

Garden party at Charles C. Chapman's home, Fullerton, California, September 5, 1914.

Garden party at Charles C. Chapman's home, Fullerton, California, 1914

Garden party at Charles C. Chapman's home, Fullerton, California, September 5, 1914.

Garden party at Charles C. Chapman's home, Fullerton, California, 1914

Garden party at Charles C. Chapman's home, Fullerton, California, September 5, 1914. Seated under a canopy with unidentified others are Mr. Harry Dierker and Mrs. C. O. Goodwin.

Family members at Charles C. Chapman's home, Fullerton, California, 1914

Family members seated outdoors at Charles C. Chapman's home, Fullerton, California, 1914. Left to right: C. C. Chapman [seated], Samuel J. Chapman with his wife standing behind him, Frank Chapman? and rest unidentified.

Home of Charles Clarke Chapman, Fullerton, California, 1914

Home of Charles Clarke Chapman, Fullerton, California, 1914.

Home of Charles Clarke Chapman, Fullerton, California

Home of Charles Clarke Chapman, Fullerton, California. Photographic postcard with "Faculty parties in May each year 1933-1940" written on back.

Formal garden of the Charles C. Chapman home, Fullerton, California

Formal garden of the Charles C. Chapman home, Fullerton, California, in the 1920s.