Immediate Decision-Making and Information Needs in Intensive Care Coordination

The aim of this study was to develop a theoretical model for information integration to support the deci¬sion making of intensive care charge nurses, and physicians in charge – that is, ICU shift leaders. The study focused on the ad hoc decision-making and immediate information needs of shift leaders during the management of an intensive care unit’s (ICU) daily activities. The term ‘ad hoc decision-making’ was defined as critical judgements that are needed for a specific purpose at a precise moment with the goal of ensuring instant and adequate patient care and a fluent flow of ICU activities. Data collection and research analysis methods were tested in the identification of ICU shift leaders’ ad hoc decision-making. Decision-making of ICU charge nurses (n = 12) and physicians in charge (n = 8) was observed using a think-aloud technique in two university-affiliated Finnish ICUs for adults. The ad hoc decisions of ICU shift leaders were identified using an application of protocol analysis. In the next phase, a structured online question¬naire was developed to evaluate the immediate information needs of ICU shift leaders. A national survey was conducted in all Finnish, university-affiliated hospital ICUs for adults (n = 17). The questionnaire was sent to all charge nurses (n = 515) and physicians in charge (n = 223). Altogether, 257 charge nurses (50%) and 96 physicians in charge (43%) responded to the survey. The survey was also tested internationally in 16 Greek ICUs. From Greece, 50 charge nurses out of 240 (21%) responded to the survey. A think-aloud technique and protocol analysis were found to be applicable for the identification of the ad hoc decision-making of ICU shift leaders. During one day shift leaders made over 200 ad hoc decisions. Ad hoc decisions were made horizontally, related to the whole intensive care process, and vertically, concerning single intensive care incidents. Most of the ICU shift leaders’ ad hoc decisions were related to human resources and know-how, patient information and vital signs, and special treatments. Commonly, this ad hoc decision-making involved several multiprofessional decisions that constituted a bundle of immediate decisions and various information needs. Some of these immediate information needs were shared between the charge nurses and the physicians in charge. The majority of which concerned patient admission, the organisation and management of work, and staff allocation. In general, the information needs of charge nurses were more varied than those of physicians. It was found that many ad hoc deci-sions made by the physicians in charge produced several information needs for ICU charge nurses. This meant that before the task at hand was completed, various kinds of information was sought by the charge nurses to support the decision-making process. Most of the immediate information needs of charge nurses were related to the organisation and management of work and human resources, whereas the information needs of the physicians in charge mainly concerned direct patient care. Thus, information needs differ between professionals even if the goal of decision-making is the same. The results of the international survey confirmed these study results for charge nurses. Both in Finland and in Greece the information needs of charge nurses focused on the organisation and management of work and human resources. Many of the most crucial information needs of Finnish and Greek ICU charge nurses were common. In conclusion, it was found that ICU shift leaders make hundreds of ad hoc decisions during the course of a day related to the allocation of resources and organisation of patient care. The ad hoc decision-making of ICU shift leaders is a complex multi-professional process, which requires a lot of immediate information. Real-time support for information related to patient admission, the organisation and man¬agement of work, and allocation of staff resources is especially needed. The preliminary information integration model can be applied when real-time enterprise resource planning systems are developed for intensive care daily management

Mapping the translation needs and practices in development co-operation projects of NGOs

Tämän pro gradu -tutkielman aiheena on kääntäminen ja viestintä vieraalla kielellä Suomen ulkoasiainministeriön rahoittamissa kansalaisjärjestöjen kehitysyhteistyöhankkeissa. Tutkielman on tarkoitus kartoittaa kyseisten kehitysyhteistyöhankkeiden kääntämiseen ja vieraskieliseen viestintään liittyviä tarpeita ja -käytäntöjä. Aihetta ei ole tutkittu laajasti muutoin, joten empiirinen osuus on erityisen merkittävässä roolissa. Tutkielman alussa esitellään ulkoasiainministeriön laatimia suomalaisten kansalaisjärjestöjen kehitysyhteistyöhankkeiden ehtoja ja ohjeita, jotka ovat kyseiselle tutkimukselle olennaisia. Tutkielman teoreettinen osuus koostuu lähinnä metodologisesta pohdinnasta, koska aiempaa tutkimustietoa on vähän. Tutkimusmetodien analysointia on painotettu myös siksi, että empiirisellä osuudella on niin suuri merkitys. Tutkielman empiirinen aineisto on yhtäältä peräisin tutkijan havainnoista, jotka saatiin omia varhaisempia hankehallinnointikokemuksia hyödyntäen sekä osallistuvan havainnoinnin menetelmää käyttäen kahden opiskelijajärjestön kehitysyhteistyöhankkeista vuosien 2009 ja 2012 välisenä aikana. Toisaalta aineisto on kerätty kyselytutkimuksen vastauksista. Kysely lähetettiin 35 suomalaiselle kansalaisjärjestölle, joiden kehitysyhteistyöhankkeita Suomen ulkoasiainministeriö rahoittaa. Järjestöt valittiin satunnaisotannalla. Empiirisen aineiston analyysistä ilmeni muun muassa, että tutkijan alkuperäinen hypoteesi kehitysyhteistyöhön liittyvien tekstien kääntämisen yleisyydestä pitää osittain paikkansa, vaikka tekstejä käännettiinkin kansalaisjärjestöissä vähemmän kuin tutkija odotti. Tutkimusaineisto ei ole kuitenkaan tarpeeksi laaja, jotta tuloksia voitaisiin yleistää, sillä kansalaisjärjestöt, niiden hankkeet, käännöstarpeet ja asiantuntemus osoittautuivat odotetusti hyvin erilaisiksi. Tulokset sisältävät asiaa myös esimerkiksi järjestöissä kääntävien ja vieraalla kielellä viestivien taustoista. Jatkotutkimukset ovat kuitenkin tarpeen, ja mahdollisia tutkimusaiheita on runsaasti.

Aspectos clínicos e patológicos em bovinos afetados por raiva com especial referência ao mapeamento do antígeno rábico por imuno-histoquímica

Este estudo retrospectivo incluiu achados clínicos e patológicos de 15 bovinos afetados por raiva. Em treze dos quinze casos, raiva foi confirmada por imunofluorescência direta. Bovinos entre 4 meses e 8 anos foram afetados. O curso clínico variou de três a sete dias. A forma paralítica foi a mais frequente e incluiu incoordenação, paresia e paralisia dos membros pélvicos, decúbito, movimentos de pedalagem e morte. Os principais achados histopatológicos foram meningoencefalite linfoplasmocitária associada com corpúsculos de Negri em 86,6% dos casos. Todos os casos foram positivos na imuno-histoquímica para raiva, cujas reações foram mais evidentes no tronco encefálico, incluindo bulbo, ponte e mesencéfalo, além de gânglio trigêmeo. A imuno-histoquímica demonstrou o vírus da raiva em axônios, dendritos e pericário de neurônios, como agregados de grânulos ou em formações arredondadas associadas com números variáveis de corpúsculos de inclusão virais nos neurônios. Houve também marcação nos neurônios de Purkinje e de seus processos na camada molecular, nos núcleos do tronco encefálico e camada profunda do córtex telencefálico. A imuno-histoquímica pode ser importante ferramenta diagnóstica no diagnóstico da raiva, especialmente em situações nas quais não é possível manter refrigeração adequada das amostras e em casos com meningoencefalite não-supurativa e ausência de corpúsculos de inclusão.

Picão-preto: uma planta daninha especial em solos tropicais

Bidens pilosa está presente em praticamente todo o território brasileiro, além de vários outros habitats tropicais. Entre as características presentes na planta, a abundante e longa produção de propágulos, o fotoblastismo preferencial, o uso eficiente da água, a elevada extração e utilização de nutrientes, bem como características morfofisiológicas específicas, conferem vantagem na competição com as principais culturas anuais e perenes. Devido à plasticidade e flexibilidade adaptativa de B. pilosa e às interações de suas características na determinação da competitividade desse vegetal, torna-se difícil identificar aquelas que realmente se associam com elevada capacidade competitiva e que possuam maior expressividade. Dentro da espécie ocorrem biótipos resistentes a determinados herbicidas, o que dificulta seu controle nas áreas agrícolas. O uso de outros métodos de manejo também possui entraves, devido à ampla variação do fluxo de disseminação, germinação e emergência de propágulos e, ainda, às associações benéficas dessa espécie com microrganismos presentes no solo. Embora seja dotada de características que a tornam infestante agressiva nas áreas agrícolas, este trabalho reporta alguns mecanismos que podem ser usados para o manejo integrado da espécie. Além disso, B. pilosa apresenta propriedades medicinais, sendo necessário o aprofundamento científico para usufruto de seus benefícios.

Toward a-state-of-the-art IR copyright management system: a needs assessment

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

Anatomia da raiz de espécies de Dyckia Schult. f. e Encholirium Mart. ex Schult. & Schult. f. (Bromeliaceae, Pitcairnioideae) da Serra do Cipó (Minas Gerais, Brasil), com especial referência ao velame

O estudo anatômico da raiz em espécies de Dyckia e Encholirium mostra, como característica marcante, a presença de uma epiderme pluriestratificada, constituindo um velame. No epivelame, encontram-se os pêlos radiculares. A hipoderme é formada por células mortas de paredes espessadas e algumas células de passagem vivas de paredes não espessadas. Em diferentes níveis, apresenta-se uni ou plurisseriada e totalmente lignificada. Observa-se, também, o espessamento e a lignificação das paredes celulares de outras regiões do córtex em maior ou menor profundidade, dependendo do nível considerado (mais próximo do caule, mais espessado). Excluindo a raiz primária da planta jovem, todas as demais são adventícias, com medula ampla.

Focus on the user: perception, expectations and needs

Esitys KDK-käytettävyystyöryhmän järjestämässä seminaarissa: Miten käyttäjien toiveet haastavat metatietokäytäntöjämme? / How users' expectations challenge our metadata practices? 30.9.2014.

The requirements and needs of global data usage in product lifecycle management

This study was done for ABB Ltd. Motors and Generators business unit in Helsinki. In this study, global data movement in large businesses is examined from a product data management (PDM) and enterprise resource planning (ERP) point-of-view. The purpose of this study was to understand and map out how a large global business handles its data in a multiple site structure and how it can be applied in practice. This was done by doing an empirical interview study on five different global businesses with design locations in multiple countries. Their master data management (MDM) solutions were inspected and analyzed to understand which solution would best benefit a large global architecture with many design locations. One working solution is a transactional hub which negates the effects of multisite transfers and reduces lead times. Also, the requirements and limitations of the current MDM architecture were analyzed and possible reform ideas given.  

Forest inventory information needs in Northwest Russia

This thesis applies the customer value hierarchy model to forestry in order to determine strategic options to enhance the value of LiDAR technology in Russian forestry. The study is conducted as a qualitative case study with semi-structured interviews as a main source of the primary data. The customer value hierarchy model constitutes a theoretical base for the research. Secondary data incorporates information on forest resource management, LiDAR technology and Russian forestry. The model is operationalised using forestry literature and forms a basis for analyses of primary data. Analyses of primary data coupled with comprehension of Russian forest inventory system and knowledge on global forest inventory have led to conclusions on the forest inventory methods selection criteria and the organizations that would benefit the most from LiDAR technology use. The thesis recommends strategic options for LiDAR technology’s value enhancement in Russian forestry.

Forest inventory information needs in Northwest Russia

This research report applies the customer value hierarchy model to forestry in order to determine strategic options to enhance the value of LiDAR technology in Russian forestry. The study is conducted as a qualitative case study with semi-structured interviews as a main source of the primary data. The customer value hierarchy model constitutes a theoretical base for the research. Secondary data incorporates information on forest resource management, LiDAR technology and Russian forestry. The model is operationalised using forestry literature and forms a basis for analyses of primary data. Analyses of primary data coupled with comprehension of Russian forest inventory system and knowledge on global forest inventory have led to conclusions on the forest inventory methods selection criteria and the organizations that would benefit the most from LiDAR technology use. The report recommends strategic options for LiDAR technology’s value enhancement in Russian forestry. This work has been conducted as a part of the project ‘Finnish-Russian Forest Academy 2 - Exploiting and Piloting’, which has been supported financially by the South-East Finland- Russia ENPI CBC 2007-2014 Programme.

Liberalismo, neoliberalismo e educação especial: algumas implicações

Este trabalho propõe-se a discutir algumas implicações do pensamento neoliberal na educação especial. Aborda aspectos relativos à regulamentação dos serviços públicos e privados de atendimento nesse setor.