Internet-based breast cancer patient’s pathway as an empowering patient educational tool

This three-phase study was conducted to examine the effect of the Breast Cancer Patient’s Pathway program (BCPP) on breast cancer patients’ empowering process from the viewpoint of the difference between knowledge expectations and perceptions of received knowledge, knowledge level, quality of life, anxiety and treatment-related side effects during the breast cancer treatment process. The BCPP is an Internet-based patient education tool describing a flow chart of the patient pathway during the breast treatment process, from breast cancer diagnostic tests to the follow-up after treatments. The ultimate goal of this study was to evaluate the effect of the BCPP to the breast cancer patient’s empowerment by using the patient pathway as a patient education tool. In phase I, a systematic literature review was carried out to chart the solutions and outcomes of Internet-based educational programs for breast cancer patients. In phase II, a Delphi study was conducted to evaluate the usability of web pages and adequacy of their content. In phase III, the BCPP program was piloted with 10 patients and patients were randomised to an intervention group (n=50) and control group (n=48). According to the results of this study, the Internet is an effective patient education tool for increasing knowledge, and BCPP can be used as a patient education method supporting other education methods. However, breast cancer patients’ perceptions of received knowledge were not fulfilled; their knowledge expectations exceed the perceived amount of received knowledge. Although control group patients’ knowledge expectations were met better with the knowledge they received in hospital compared to the patients in the intervention group, no statistical differences were found between the groups in terms of quality of life, anxiety and treatment-related side effects. However, anxiety decreased faster in the intervention group when looking at internal differences between the groups at different measurement times. In the intervention group the relationship between the difference between knowledge expectations and perceptions of received knowledge correlated significantly with quality of life and anxiety. Their knowledge level was also significant higher than in the control group. These results support the theory that the empowering process requires patient’s awareness of knowledge expectations and perceptions of received knowledge. There is a need to develop patient education to meet patients’ perceptions of received knowledge, including oral and written education and BCPP, to fulfil patient’s knowledge expectations and facilitate the empowering process. Further research is needed on the process of cognitive empowerment with breast cancer patients. There is a need for new patient education methods to increase breast cancer patients’ awareness of knowing.

Applications of Industrial Statistics

This dissertation examines knowledge and industrial knowledge creation processes. It looks at the way knowledge is created in industrial processes based on data, which is transformed into information and finally into knowledge. In the context of this dissertation the main tool for industrial knowledge creation are different statistical methods. This dissertation strives to define industrial statistics. This is done using an expert opinion survey, which was sent to a number of industrial statisticians. The survey was conducted to create a definition for this field of applied statistics and to demonstrate the wide applicability of statistical methods to industrial problems. In this part of the dissertation, traditional methods of industrial statistics are introduced. As industrial statistics are the main tool for knowledge creation, the basics of statistical decision making and statistical modeling are also included. The widely known Data Information Knowledge Wisdom (DIKW) hierarchy serves as a theoretical background for this dissertation. The way that data is transformed into information, information into knowledge and knowledge finally into wisdom is used as a theoretical frame of reference. Some scholars have, however, criticized the DIKW model. Based on these different perceptions of the knowledge creation process, a new knowledge creation process, based on statistical methods is proposed. In the context of this dissertation, the data is a source of knowledge in industrial processes. Because of this, the mathematical categorization of data into continuous and discrete types is explained. Different methods for gathering data from processes are clarified as well. There are two methods for data gathering in this dissertation: survey methods and measurements. The enclosed publications provide an example of the wide applicability of statistical methods in industry. In these publications data is gathered using surveys and measurements. Enclosed publications have been chosen so that in each publication, different statistical methods are employed in analyzing of data. There are some similarities between the analysis methods used in the publications, but mainly different methods are used. Based on this dissertation the use of statistical methods for industrial knowledge creation is strongly recommended. With statistical methods it is possible to handle large datasets and different types of statistical analysis results can easily be transformed into knowledge.

Frequency of fear of needles and impact of a multidisciplinary educational approach towards pregnant women with diabetes

PURPOSE: To evaluate the frequency of fear of needles and the impact of a multidisciplinary educational program in women with pre-gestational and gestational diabetes taking insulin during pregnancy. METHODS: The short Diabetes Fear of Injecting and Self-testing Questionnaire (D-FISQ), composed by two subscales that access fear of self injection (FSI) and fear of self testing (FST), was administered twice during pregnancy to 65 pregnant women with pre-gestational and gestational diabetes: at the first endocrine consult and within the last two weeks of pregnancy or postpartum. An organized multidisciplinary program provided diabetes education during pregnancy. Statistical analysis was carried out by Wilcoxon and McNemar tests and Spearman correlation. A p<0.05 was considered to be significant. RESULTS: Data from the short D-FISQ questionnaire shows that 43.1% of pregnant women were afraid of needles in the first evaluation. There was a significant reduction in scores for FSI and FST subscales between the first and second assessments (first FSI 38.5% compared with second 12.7%, p=0.001; first FST 27.7% compared with second FST 14.3%, p=0.012). CONCLUSIONS: The fear of needles is common in pregnant women on insulin therapy and an organized multidisciplinary educational diabetes program applied during pregnancy reduces scores of such fear.

The Changing Role of the CIO: Developing Skills by Means of Postgraduate Educational Programs

The objective of this research was to identify the skills and competences required by Chief Information Officers in their professional life and whether these skills can be developed by means of postgraduate education pro-grams. Although the changing role of the CIO has been studied for years by the academia, the ways of necessary skills development have not been paid significant attention. In order to obtain understanding of the topic and its main issues qualitative method was implemented and questionnaires and interviews were conducted with CIOs and other C-level executives to-gether with analysis of the curricula of postgraduate educational programs in the field of business designed for executives. Business skills and knowledge along with developed communication and leadership skills are among the most discussed and required from CIOs. According to the collected data and its further analysis, although the most important competences of an IT executive are technological, the im-portance of business related skills is emphasized by the majority of re-spondents and supported by the existing theory. Postgraduate educational programs have curricula that can develop the required competences, alt-hough not equally.

Prevalence of metabolic syndrome and its association with educational inequalities among Brazilian adults: a population-based study

The present study estimated the prevalence of metabolic syndrome (MS) according to the criteria established by the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATPIII) and the International Diabetes Federation (IDF) and analyzed the contribution of social factors in an adult urban population in the Southeastern region of Brazil. The sample plan was based on multistage probability sampling according to family head income and educational level. A random sample of 1116 subjects aged 30 to 79 years was studied. Participants answered a questionnaire about socio-demographic variables and medical history. Fasting capillary glucose (FCG), total cholesterol, high-density lipoprotein cholesterol (HDL-C), and triglycerides were determined and all non-diabetic subjects were submitted to the 75-g oral glucose tolerance test. Body mass index (BMI, kg/m²), waist circumference and blood pressure (BP) were determined. Age- and gender-adjusted prevalence of MS was 35.9 and 43.2% according to NCEP-ATPIII and IDF criteria, respectively. Substantial agreement was found between NCEP-ATPIII and IDF definitions. Low HDL-C levels and high BP were the most prevalent MS components according to NCEP-ATPIII criteria (76.3 and 59.2%, respectively). Considering the diagnostic criteria adopted, 13.5% of the subjects had diabetes and 9.7% had FCG ≥100 mg/dL. MS prevalence was significantly associated with age, skin color, BMI, and educational level. This cross-sectional population-based study in the Southeastern region of Brazil indicates that MS is highly prevalent and associated with an important social indicator, i.e., educational level. This result suggests that in developing countries health policy planning to reduce the risk of MS, in particular, should consider improvement in education.

Discerning Cultural Depictions and Mistakes in Kafe Piter, a Russian Language Textbook for Finnish Students

This thesis presents the results of an analysis of the content in the series of Russian textbooks Kafe Piter, which is widely used in Finnish educational institutions for adult learners at the time that the research is conducted. The purpose of this study is to determine and describe how a textbook may purvey an image of a foreign country (in this case, Russia). Mixed-methods research with a focus on the qualitative content analysis of Kafe Piter is performed. The guidelines for textbook evaluation of cultural content proposed by Byram (1993) are used in this study as the basis for creating a qualitative analysis checklist, which is adopted according to the needs of the current research. The selection of the categories in the checklist is based on major themes where direct statements about Russia, Russian people and culture appear in the textbook. The cultural content and the way in which it is presented in Kafe Piter are also compared to the intercultural competence objectives of the Common European Framework of Reference for Languages. Because the textbook was not written by a native Russian speaker, it was also important to investigate the types of mistakes found in the books. A simple quantitative analysis in the form of descriptive statistics was done, which consisted of counting the mistakes and inaccuracies in Kafe Piter. The mistakes were categorized into several different groups: factual or cultural, lexicosemantic, grammatical, spelling and punctuation mistakes. Based on the results, the cultural content of Kafe Piter provides a rich variety of cultural information that allows for a good understanding of the Russian language and Russian culture. A sufficient number of cross-cultural elements also appear in the textbook, including cultural images and information describing and comparing Russian and Finnish ways of life. Based on the cultural topics covered in Kafe Piter, we conclude that the textbook is in line with the intercultural competence objectives set out in the Common European Framework of Reference for Languages. The results of the study also make it clear that a thorough proofreading of Kafe Piter is needed in order to correct mistakes - more than 130 cultural and linguistic mistakes and inaccuracies appear in the textbook.

Grassroots Charity in China: Case Analysis of a Charity Project Organised by Jane Zhang Fan Club

As unregistered grassroots charities do not appear in official statistics in China, they tend to remain unnoticed by scholars. Also as they operate unofficially and avoid publicity, their work is usually not reported by the media. In this research I explore the grassroots charity activity of one pop music fan club from the viewpoint of trust as a sociological concept. I will also establish the general situation on charity in China. By using textual analysis on internet blogs and discussion forums I map the charity project from the discussion of the original idea to the execution and follow up phase. I study the roles the fan club members assume during the project as anonymous participants of internet conversations, as well as concrete active charity volunteers outside of the virtual world. I establish parties, other than the fan club, which are involved in the charity project. Interviews with one of the participant of the project in 2010, 2014 and 2015 bring valuable additional information and help in distributing the questionnaire survey. A quantitative questionnaire survey was distributed among the fan club members to get more detailed information on the motives and attitudes towards official and unofficial charity in China. Because of the inequality in China, the rural minority areas do not have similar educational opportunities as the mostly majority inhabited urban areas, even though the country officially has a nine year compulsory education. Grassroots charities can operate in relative freedom taking some of the government’s burden of social responsibilities if they are not criticizing the authorities. The problem with grassroots charity seems to be lack of sustainability. The lack of trust for authorities and official charities was the reason why the Jane Zhang fan club decided to conduct a charity case unofficially. As a group of people previously unknown to each other, they managed to build mutual trust to carry out the project transparently and successfully, though not sustainably. The internet has provided a new and effective platform for unofficial grassroots charities, who choose not to co-operate with official organisations. On grassroots level charities can have the transparency and trust that lack from official charities. I suggest, that interviewing the real persons behind the internet aliases and finding out what happened outside the discussion forums, would bring a more detailed and outspoken description of the project concerning of the contacts with the local authorities. Also travelling to the site and communicating with the local people in the village would establish how they have experienced the project.

Development and Effect Analysis of the Asteri Consultative Auditing Process - Safety and Security Management in Educational Institutions

The Finnish legislation requires for a safe and secure learning environment. However, the comprehensive, risk based safety and security management (SSM) and the management commitment in the implementation and development of the SSM are not mentioned in the legislation. Multiple institutions, operators and researchers have studied and developed safety and security in educational institutions over the past decade. Typically the approach has been fragmented and without bringing up the importance of the comprehensive SSM. The development needs of the safety and security operations in universities have been studied. However, in universities of applied sciences (UASs) and in elementary schools (ESs), the performance level, strengths and weaknesses of the comprehensive SSM have not been studied. The objective of this study was to develop the comprehensive, risk based SSM of educational institutions by developing the new Asteri consultative auditing process and study its effects on auditees. Furthermore, the performance level in the comprehensive SSM in UASs and ESs were studied using Asteri and the TUTOR model developed by the Keski-Uusimaa Department for Rescue Services. In addition, strengths, development needs and differences were identified. In total, 76 educational institutions were audited between the years 2011 and 2014. The study is based on logical empiricism, and an observational applied research design was used. Auditing, observation and an electronic survey were used for data collection. Statistical analysis was used to analyze the collected information. In addition, thematic analysis was used to analyze the development areas of the organizations mentioned by the respondents in the survey. As one of the main contributions, this research presents the new Asteri consultative auditing process. Organizations with low performance levels on the audited subject benefit the most from the Asteri consultative auditing process. Asteri may be usable in many different types of audits, not only in SSM audits. As a new result, this study provides new knowledge on attitudes related to auditing. According to the research findings, auditing may generate negative attitudes and the auditor should take them into account when planning and preparing for audits. Negative attitudes can be compensated by producing added value, objectivity and positivity for the audit and, thus, improve the positive effects of auditing on knowledge and skills. Moreover, as the results of this study shows, auditing safety and security issues do not increase feelings of insecurity, but rather increase feelings of safety and security when using the new Asteri consultative auditing process with the TUTOR model. The results showed that the SSM in the audited UASs was statistically significantly more advanced than that in the audited ESs. However, there is still room for improvement in the ESs and the UASs as the approach to the SSM was fragmented. It can be assumed that the majority of Finnish UASs and ESs do not likely meet the basic level of the comprehensive, risk based the SSM.