What are the opportunities and challenges of cloud computing technology in the healthcare information systems

This thesis discusses the opportunities and challenges of the cloud computing technology in healthcare information systems by reviewing the existing literature on cloud computing and healthcare information system and the impact of cloud computing technology to healthcare industry. The review shows that if problems related to security of data are solved then cloud computing will positively transform the healthcare institutions by giving advantage to the healthcare IT infrastructure as well as improving and giving benefit to healthcare services. Therefore, this thesis will explore the opportunities and challenges that are associated with cloud computing in the context of Finland in order to help the healthcare organizations and stakeholders to determine its direction when it decides to adopt cloud technology on their information systems.

“Development work thesis” as a tool for continuing professional education

Julkaisumaa: 158 TW TWN Taiwan

Productizing professional marketing services through service blueprinting

The goal of this research is to study how knowledge-intensive business services can be productized by using the service blueprinting tool. As services provide the majority of jobs, GDP and productivity growth in Europe, their continuous development is needed for Europe to retain its global competitiveness. As services are turning more complex, their development becomes more difficult. The theoretical part of this study is based on researching productization in the context of knowledge-intensive business services. The empirical part is carried out as a case study in a KIBS company, and utilizes qualitative interviews and case materials. The final outcome of this study is an updated productization framework, designed for KIBS companies, and recommendations for the case company. As the results of this study indicate, productization expanded with service blueprinting can be a useful tool for KIBS companies to develop their services. The updated productization framework is provided for future reference.

Public and private sector cooperative opportunities in the Finnish healthcare internationalization : views from the public sector’s perspective

Traditionally mostly publicly provided Finnish healthcare services are confronted today by the evident challenge of rising healthcare costs as the expenditure on health and social case has exceeded Finland’s national GDP growth significantly since the new millennium. While the opening of the traditional barriers through the EU’s new patient directive resulting in increasing international competition and the free flow of patients within the EU present opportunities for the Finnish healthcare services industry there are also several challenges for the existing healthcare system as proposed by the Ministry of Employment and the Economy in 2011. Due to the structure and nature of the current Finnish healthcare service system the greatest potential for internationalization is seen from a joint cooperation of the public and private sectors in an internationalization network for Finnish healthcare services. As its formation has recently also taken as a strategic initiative to be completed by the Ministry of Employment and the Economy and no earlier research exists on how this is seen in practice by the network actors, the purpose of this study is to examine the proposed solution of forming an internationalization network between the public and private sector actors in Finland in practice from the viewpoint of public sector actors. The research relied heavily on the reports by the Finnish Ministries in understanding the current situation of the Finnish healthcare services internationalization and its potential. Suitable theories were also used to build a more comprehensive view of the matter. The study applied a qualitative research approach on the explorative research problem. The data collection was achieved through expert interviews in two of the largest Finnish public healthcare service providers; the Turku and Helsinki Central University Hospitals. Expert interviews were considered as the most suitable method for data collection in order to create an in-depth understanding of the topic within the limitations of this thesis. In turn, two different public healthcare service providers were chosen to give a broader view of the field instead of focusing on a specific unit and also to allow a possible comparison between the two different organizations. The latter however was shown not to be suitable for the purposes of this study as the opinions of the respondents varied largely also within their own organizations. The conclusion is that while the actors agree on the evident internationalization of Finnish healthcare services, there are several large-scale structural challenges effectively preventing such activities while at the same time the opportunities within Finland vary, as there are several niches but no real large-scale advantages in the highly competitive industry. Interest towards cooperation between the sectors are seen especially in exploiting the advantages offered by the private sector in commercialization and marketization, yet however no clear views exist on how these activities should be governed or structured in the short-term as a larger reform of the entire Finnish healthcare service sector is needed in the long-term.

Balancing creativity and risk intelligence in professional knowledge-intensive business services

The main strengths of professional knowledge-intensive business services (P-KIBS) are knowledge and creativity which needs to be fostered, maintained and supported. The process of managing P-KIBS companies deals with financial, operational and strategic risks. That is why it is reasonable to apply risk management techniques and frameworks in this context. A significant challenge hides in choosing reasonable ways of implementing risk management, which will not limit creative ability in organization, and furthermore will contribute to the process. This choice is related to a risk intelligent approach which becomes a justified way of finding the required balance. On a theoretical level the field of managing both creativity and risk intelligence as a balanced process remains understudied in particular within KIBS industry. For instance, there appears to be a wide range of separate models for innovation and risk management, but very little discussion in terms of trying to find the right balance between them. This study aims to shed light on the importance of well-managed combination of these concepts. The research purpose of the present study is to find out how the balance between creativity and risk intelligence can be managed in P-KIBS. The methodological approach utilized in the study is strictly conceptual without empirical aspects. The research purpose can be achieved through answering the following research supporting questions: 1. What are the characteristics and role of creativity as a component of innovation process in a P-KIBS company? 2. What are the characteristics and role of risk intelligence as an approach towards risk management process implementation in a P-KIBS company? 3. How can risk intelligence and creativity be balanced in P-KIBS? The main theoretical contribution of the study conceals in a proposed creativity and risk intelligence stage process framework. It is designed as an algorithm that can be applied on organizational canvas. It consists of several distinct stages specified by actors involved, their roles and implications. Additional stage-wise description provides detailed tasks for each of the enterprise levels, while combining strategies into one. The insights driven from the framework can be utilized by a vast range of specialists from strategists to risk managers, and from innovation managers to entrepreneurs. Any business that is designing and delivering knowledge service can potentially gain valuable thoughts and expand conceptual understanding from the present report. Risk intelligence in the current study is a unique way of emphasizing the role of creativity in professional knowledge-intensive industry and a worthy technique for making profound decisions towards risks.

Usability metric design for prenatal healthcare information system

This work goes through the concept of usability in general and healthcare, especially prenatal healthcare, context. Different frameworks and guidelines used to measure it are considered. A collection of metrics is suggested to be used at a prenatal unit of one Finnish healthcare district. The metrics consist of a set of 12 general measures and a supplementary System Usability Scale questionnaire including a Fun Toolkit Smileyometer. The metrics are tested in real life work situations by observing meetings with patients and presenting the questionnaire for the focus group personnel. A total of 6 focus group patient meetings were observed. This work suggests that in order to get more conclusive data from the metrics the focus groups need to be more involved and observation situations need to be more controlled. Revised metrics consist of the 12 general measures.

Indoor NO2 air pollution and lung function of professional cooks

Studies of cooking-generated NO2 effects are rare in occupational epidemiology. In the present study, we evaluated the lung function of professional cooks exposed to NO2 in hospital kitchens. We performed spirometry in 37 cooks working in four hospital kitchens and estimated the predicted FVC, FEV1 and FEF25-75, based on age, sex, race, weight, and height, according to Knudson standards. NO2 measurements were obtained for 4 consecutive days during 4 different periods at 20-day intervals in each kitchen. Measurements were performed inside and outside the kitchens, simultaneously using Palm diffusion tubes. A time/exposure indicator was defined as representative of the cumulative exposure of each cook. No statistically significant effect of NO2 exposure on FVC was found. Each year of work as a cook corresponded to a decrease in predicted FEV1 of 2.5% (P = 0.046) for the group as a whole. When smoking status and asthma were included in the analysis the effect of time/exposure decreased about 10% and lost statistical significance. On predicted FEF25-75, a decrease of 3.5% (P = 0.035) was observed for the same group and the inclusion of controllers for smoking status and asthma did not affect the effects of time/exposure on pulmonary function parameter. After a 10-year period of work as cooks the participants of the study may present decreases in both predicted FEV1 and FEF25-75 that can reach 20 and 30%, respectively. The present study showed small but statistically significant adverse effects of gas stove exposure on the lung function of professional cooks.

Stability of relative oxygen pulse curve during repeated maximal cardiopulmonary testing in professional soccer players

During cardiopulmonary exercise testing (CPET), stroke volume can be indirectly assessed by O2 pulse profile. However, for a valid interpretation, the stability of this variable over time should be known. The objective was to analyze the stability of the O2 pulse curve relative to body mass in elite athletes. VO2, heart rate (HR), and relative O2 pulse were compared at every 10% of the running time in two maximal CPETs, from 2005 to 2010, of 49 soccer players. Maximal values of VO2 (63.4 ± 0.9 vs 63.5 ± 0.9 mL O2•kg-1•min-1), HR (190 ± 1 vs188 ± 1 bpm) and relative O2 pulse (32.9 ± 0.6 vs 32.6 ± 0.6 mL O2•beat-1•kg-1) were similar for the two CPETs (P > 0.05), while the final treadmill velocity increased from 18.5 ± 0.9 to 18.9 ± 1.0 km/h (P < 0.01). Relative O2 pulse increased linearly and similarly in both evaluations (r² = 0.64 and 0.63) up to 90% of the running time. Between 90 and 100% of the running time, the values were less stable, with up to 50% of the players showing a tendency to a plateau in the relative O2 pulse. In young healthy men in good to excellent aerobic condition, the morphology of the relative O2 pulse curve is consistent up to close to the peak effort for a CPET repeated within a 1-year period. No increase in relative O2pulse at peak effort could represent a physiologic stroke volume limitation in these athletes.

Translating with the Web. Professional translators' information-seeking behaviour in translation with online resources

Tämän tutkielman aiheena on ammattikääntäjien tiedonhaku, kun käytettävissä on ainoastaan verkkolähteitä. Tutkimuksessa on tarkasteltu, mistä ja miten ammattikääntäjät etsivät tietoa internetistä kääntäessään lähtötekstiä englannista suomeen. Lisäksi tutkimuksen tarkoituksena on osoittaa, että tiedonhakutaidot ja lähdekriittisyys ovat käännöskompetensseja, joita tulisi sekä ylläpitää että opettaa osana kääntäjäkoulutusta. Tutkimuksen aineisto kerättiin empiirisesti käyttämällä kolmea metodia. Käännösprosessi ja sen aikana tapahtunut tiedonhaku tallennettiin käyttäen Camtasia-näyttövideointiohjelmaa ja Translog-II -näppäilyntallennusohjelmaa. Lisäksi tutkimukseen osallistuneet kääntäjät täyttivät kaksi kyselyä, joista ensimmäinen sisälsi taustatietokysymyksiä ja toinen itse prosessiin liittyviä retrospektiivisiä kysymyksiä. Kyselyt toteutettiin Webropol-kyselytyökalulla. Aineistoa kerättiin yhteensä viidestä koetilanteesta. Tutkimuksessa tarkasteltiin lähemmin kolmen ammattikääntäjän tiedon-hakutoimintoja erottelemalla käännösprosesseista ne tauot, joiden aikana kääntäjät etsivät tietoa internetistä. Käytettyjen verkkolähteiden osalta tutkimuksessa saatiin vastaavia tuloksia kuin aiemmissakin tutkimuksissa: eniten käytettyjä olivat Google, Wikipedia sekä erilaiset verkkosanakirjat. Tässä tutkimuksessa kuitenkin paljastui, että ammattikääntäjien tiedonhaun toimintamallit vaihtelevat riippuen niin kääntäjän erikoisalasta kuin hänen tiedonhakutaitojensa tasosta. Joutuessaan työskentelemään tutun työympäristönsä ja oman erikoisalansa ulkopuolella turvautuu myös osa ammattikääntäjistä alkeellisimpiin tiedonhakutekniikoihin, joita käännöstieteen opiskelijoiden on havaittu yleisesti käyttävän. Tulokset paljastivat myös, että tiedonhaku voi viedä jopa 70 prosenttia koko käännösprosessiin kuluvasta ajasta riippuen kääntäjän aiemmasta lähtötekstin aihepiiriin liittyvästä tietopohjasta ja tiedonhaun tehokkuudesta. Tutkimuksessa saatujen tulosten pohjalta voidaan sanoa, että myös ammattikääntäjien tulisi kehittää tiedonhakutaitojaan pitääkseen käännösprosessinsa tehokkaana. Lisäksi kääntäjien pitäisi muistaa arvioida kriittisesti käyttämiään tietolähteitä: lähdekritiikki on tarpeen erityisesti verkkolähteitä käytettäessä. Tästä syystä tiedonhakutaitoja ja lähdekriittisyyttä tulisikin opettaa ja harjoitella jo osana kääntäjäkoulutusta. Kääntäjien ei myöskään pidä jättää tiedonhakua pelkkien verkkolähteiden varaan, vaan jatkossakin käyttää hyväkseen niin painettuja tietolähteitä kuin myös henkilölähteitä.

Improving oral healthcare in Scotland with special reference to sustainability and caries prevention

Brett Duane Improving oral healthcare in Scotland with special reference to sustainability and caries prevention University of Turku, Faculty of Medicine, Institute of Dentistry, Community Dentistry, Finnish Doctoral Program in Oral Sciences (FINDOS-Turku), Turku, Finland Annales Universitatis Turkuensis, Sarja- Ser. D, Medica-Odontologica. Painosalama Oy, Turku, Finland, 2015. Dentistry must provide sustainable, evidence-based, and prevention-focused care. In Scotland oral health prevention is delivered through the Childsmile programme, with an increasing use of high concentration fluoride toothpaste (HCFT). Compared with other countries there is little knowledge of xylitol prevention. The UK government has set strict carbon emission limits with which all national health services (NHS) must comply. The purpose of these studies was firstly to describe the Scottish national oral health prevention programme Childsmile (CS), to determine if the additional maternal use of xylitol (CS+X) was more effective at affecting the early colonisation of mutans streptococci (MS) than this programme alone; secondly to analyse trends in the prescribing and management of HCFT by dentists; and thirdly to analyse data from a dental service in order to improve its sustainability. In all, 182 mother/child pairs were selected on the basis of high maternal MS levels. Motherswere randomly allocated to a CS or CS+X group, with both groups receiving Childsmile. Theintervention group consumed xylitol three times a day, from when the child was 3 months until 24 months. Children were examined at age two to assess MS levels. In order to understand patterns of HCFT prescribing, a retrospective secondary data analysis of routine prescribing data for the years 2006-2012 was performed. To understand the sustainability of dental services, carbon accounting combined a top-down approach and a process analysis approach, followed by the use of Pollard’s decision model (used in other healthcare areas) to analyse and support sustainable service reconfiguration. Of the CS children, 17% were colonised with MS, compared with 5% of the CS+X group. This difference was not statistically significant (P=0.1744). The cost of HCFT prescribing increased fourteen-fold over five years, with 4% of dentists prescribing 70% of the total product. Travel (45%), procurement (36%) and building energy (18%) all contributed to the 1800 tonnes of carbon emissions produced by the service, around 4% of total NHS emissions. Using the analytical model, clinic utilisation rates improved by 56% and patient travel halved significantly reducing carbon emissions. It can be concluded that the Childsmile programme was effective in reducing the risk for MS transmission. HCFT is increasing in Scotland and needs to be managed. Dentistry has similar carbon emissions proportionally as the overall NHS, and the use of an analytic tool can be useful in helping identify these emissions. Key words: Sustainability, carbon emissions, xylitol, mutans streptococci, fluoride toothpaste, caries prevention.