Le médecin au centre: pour une approche de l'expérience vécue [Toward the lived experience of the physician].

For manyyears, a major focus of interest has been the patient, in the context of a constantly changing society and increasingly complex medical practices. We propose to shift this focus on the physician, who is entangled in a similar, but less evident way. In these three articles, we explore, in succession, the lived experience of the contemporary physician, the ethos which brings together the medical community, and the education of the future physician, using research projects currently under way within the Service of Liaison Psychiatry at Lausanne University Hospital. In this first article, we particularly raise the question of what is the lived experience of the physician and sketch the outline of <physician-centered> research.

Luottamuksen rooli muutosjohtamisessa

Pro gradu – tutkielman tavoitteena oli tutkia luottamuksen roolia muutosjohtamisessa. Tarkoituksena oli selvittää luottamuksen tukemisen ja rakentamisen keinoja muutosjohtamisen tueksi muutosprosessin eri osa-alueilla. Tutkimusaineisto kerättiin kvalitatiivisten teemahaastattelujen avulla. Haastattelujen osiot liitettiin tutkimuksen empiiriseen osaan. Tutkimuksen perusteella saatiin selkeä kuva siitä, mihin luottamus vaikuttaa, miten sitä rakennetaan ja mitkä ovat sen seuraamukset muutosprosessin eri osa-alueilla. Tutkimuksen kohteena oleva organisaatioiden välinen vapaaehtoinen ja sopimuspohjainen verkostoyhteistyö ei olisi onnistunut ilman luottamusta. Luottamuksen merkitys muutosjohtamisprosessissa tulee tiedostaa ja siihen tulee kiinnittää tietoisesti huomiota koko prosessin ajan. Muutos on johdettava ja luottamuksen rakentaminen on osa sitä prosessia.

Comovement of stock price risk in strategic alliance — Case: mobile internet

The focus of this study has been comovement of stock price risk level between two companies as they form strategic alliance. Thus the main reason has been to shed more light to possible increased risk level that the stockholder confronts when a company he owns forms a strategic alliance with another company. This study has centralized to interfirm cooperation between mobile and internet companies, which have furthered the development of mobile internet. The study has been divided into theoretical and empirical part. In theoretical part the main concepts riskiness of a stock (volatility), comovement and strategic alliance have been run through. In empirical part seven strategic alliances formed by mobile internet companies have been examined. Based on this, strategic alliance seems to increase comovement of stock price risk in some degree. This comovement seems to be stronger when core businesses or operating environments of cooperating companies differ more from each other.

Managing the Front End of Innovation in a Networked Company Environment - Combining Strategy, Processes and Systems of Innovation

The objective of the thesis is to enhance the understanding about the management of the front end phases of the innovation process in a networked environment. The thesis approaches the front end of innovation from three perspectives, including the strategy, processes and systems of innovation. The purpose of the use of different perspectives in the thesis is that of providing an extensive systemic view of the front end, and uncovering the complex nature of innovation management. The context of the research is the networked operating environment of firms. The unit of analysis is the firm itself or its innovation processes, which means that this research approaches the innovation networks from the point of view of a firm. The strategy perspective of the thesis emphasises the importance of purposeful innovation management, the innovation strategy of firms. The role of innovation processes is critical in carrying out innovation strategies in practice, supporting the development of organizational routines for innovation, and driving the strategic renewal of companies. The primary focus of the thesis from systems perspective is on idea management systems, which are defined as a part of innovation management systems, and defined for this thesis as any working combination of methodology and tools (manual or IT-supported) that enhance the management of innovations within their early phases. The main contribution of the thesis are the managerial frameworks developed for managing the front end of innovation, which purposefully “wire” the front end of innovation into the strategy and business processes of a firm. The thesis contributes to modern innovation management by connecting the internal and external collaboration networks as foundational elements for successful management of the early phases of innovation processes in a dynamic environment. The innovation capability of a firm is largely defined by its ability to rely on and make use of internal and external collaboration already during the front end activities, which by definition include opportunity identification and analysis, idea generation, profileration and selection, and concept definition. More specifically, coordination of the interfaces between these activities, and between the internal and external innovation environments of a firm is emphasised. The role of information systems, in particular idea management systems, is to support and delineate the innovation-oriented behaviour and interaction of individuals and organizations during front end activities. The findings and frameworks developed in the thesis can be used by companies for purposeful promotion of their front end processes. The thesis provides a systemic strategy framework for managing the front end of innovation – not as a separate process, but as an elemental bundle ofactivities that is closely linked to the overall innovation process and strategy of a firm in a distributed environment. The theoretical contribution of the thesis relies on the advancement of the open innovation paradigm in the strategic context of a firm within its internal and external innovation environments. This thesis applies the constructive research approach and case study methodology to provide theoretically significant results, which are also practically beneficial.

Effects of pulp electrochemistry on PGE flotation in sulphide poor ores

This work gives a reader basic knowledge about mineralogy and mineral processing. Main focus of this work was on flotation process and pulp electrochemistry on flotation. Three different sulphide poor ores are examined on experimental part. Platinum and palladium were the noble metals, which were contained into studied ores. Electrochemistry of flotation of PGE minerals on sulphide poor ores has been examined only slightly. Bench scale flotation test was used in this study. Chalcopyrite, nickel-pentlandite, pyrite, platinum and pH electrodes were used to investigation of pulp electrochemistry during flotation tests. Effects of grinding media, carbon dioxide atmosphere in grinding and mixture of carbon dioxide and air as flotation gas to PGE flotation and electrochemistry of flotation were studied. Stainless steel grinding media created more oxidising pulp environment to flotation than mild steel grinding media. Concentrate quality improved also with stainless steel grinding media, but the recovery was remarkably poorer, than with mild steel grinding media. Carbon dioxide atmosphere in grinding created very reducing pulp environment, which caused very good concentrate quality. But the recovery was again poorer than with normal mild steel grinding media. Mixture of carbon dioxide and air as flotation gas improved PGE recovery with some ores, but not always. Effect of carbon dioxide to pulp electrochemistry was detected mainly via pH-value.

Role of Selected Spectral Attributes in the Perception of Synthetic Vowels

This thesis is an experimental study regarding the identification and discrimination of vowels, studied using synthetic stimuli. The acoustic attributes of synthetic stimuli vary, which raises the question of how different spectral attributes are linked to the behaviour of the subjects. The spectral attributes used are formants and spectral moments (centre of gravity, standard deviation, skewness and kurtosis). Two types of experiments are used, related to the identification and discrimination of the stimuli, respectively. The discrimination is studied by using both the attentive procedures that require a response from the subject, and the preattentive procedures that require no response. Together, the studies offer information about the identification and discrimination of synthetic vowels in 15 different languages. Furthermore, this thesis discusses the role of various spectral attributes in the speech perception processes. The thesis is divided into three studies. The first is based only on attentive methods, whereas the other two concentrate on the relationship between identification and discrimination experiments. The neurophysiological methods (EEG recordings) reveal the role of attention in processing, and are used in discrimination experiments, while the results reveal differences in perceptual processes based on the language, attention and experimental procedure.

Efficiency and Equity in Learning Communities and schools

Traditionally, school efficiency has been measured as a function of educational production. In the last two decades, however, studies in the economics of education have indicated that more is required to improve school efficiency: researchers must explore how significant changes in school organization affect the performance of at-risk students. In this paper we introduce Henry Levin’s adoption of the X-efficiency approach to education and we describe the efficient and cost-effective characteristics of one Learning Communities Project School that significantly improved its student outcomes and enrollment numbersand reduced its absenteeism rate to zero. The organizational change that facilitatedthese improvements defined specific issues to address. Students’ school success became the focus of the school project, which also offered specific incentives, selected teachers, involved parents and community members in decisions, and used the most efficient technologies and methods. This case analysis reveals new two elements—family training and community involvement—that were not explicit parts of Levin’s adaptation. The case of the Antonio Machado Public School should attract the attention of both social scientists and policy makers

Analyzing the cost-efficiency and performance of a payroll department by benchmarking

Tämän diplomityön tavoitteena oli analysoida Stora Enson palkkakeskuksen ja sen henkilöstöhallinnon järjestelmän, SAP HR:n, kustannustehokkuutta ja suorituskykyä. Tutkimuksessa käytettiin apuna benchmarkingia. Viisi suurta suomalaisyritystä osallistui benchmarkingiin. Benchmarkingin pääkohteena oli yritysten välinen kustannusvertailu. Kyselyssä perehdyttiin myös yritysten järjestelmien suorituskykyyn. Tuloksien perusteella Stora Enson palkkakeskus tarjoaa kustannustehokkaan ja kilpailukykyisen ratkaisun, joka menestyy hyvin vertailussa muihin suomalaisiin yrityksiin.

Development of beam and plate finite elements based on the absolute nodal coordinate formulation

The focus of this dissertation is to develop finite elements based on the absolute nodal coordinate formulation. The absolute nodal coordinate formulation is a nonlinear finite element formulation, which is introduced for special requirements in the field of flexible multibody dynamics. In this formulation, a special definition for the rotation of elements is employed to ensure the formulation will not suffer from singularities due to large rotations. The absolute nodal coordinate formulation can be used for analyzing the dynamics of beam, plate and shell type structures. The improvements of the formulation are mainly concentrated towards the description of transverse shear deformation. Additionally, the formulation is verified by using conventional iso-parametric solid finite element and geometrically exact beam theory. Previous claims about especially high eigenfrequencies are studied by introducing beam elements based on the absolute nodal coordinate formulation in the framework of the large rotation vector approach. Additionally, the same high eigenfrequency problem is studied by using constraints for transverse deformation. It was determined that the improvements for shear deformation in the transverse direction lead to clear improvements in computational efficiency. This was especially true when comparative stress must be defined, for example when using elasto-plastic material. Furthermore, the developed plate element can be used to avoid certain numerical problems, such as shear and curvature lockings. In addition, it was shown that when compared to conventional solid elements, or elements based on nonlinear beam theory, elements based on the absolute nodal coordinate formulation do not lead to an especially stiff system for the equations of motion.

Effects of landscape evolution on flora and habitats in agricultural mosaics

A landscape mosaic is a landscape that consist of various patches, inhabited by different habitat communities over time. Agricultural mosaics area result of the long history between societies and the environment. The understanding of the driving forces for change in this landscapes, and their effect on biodiversity, allow the development of useful tools to assess and manage natural heritage. Plant diversity, endangered plant species and interesting habitats receive the center of attention, because of their capability to integrate and reflect the main changes of this landscapes after medium and long-term.

Engineering of Business Critical Web Applications

Research focus of this thesis is to explore options for building systems for business critical web applications. Business criticality here includes requirements for data protection and system availability. The focus is on open source software. Goals are to identify robust technologies and engineering practices to implement such systems. Research methods include experiments made with sample systems built around chosen software packages that represent certain technologies. The main research focused on finding a good method for database data replication, a key functionality for high-availability, database-driven web applications. Research included also finding engineering best practices from books written by administrators of high traffic web applications. Experiment with database replication showed, that block level synchronous replication offered by DRBD replication software offered considerably more robust data protection and high-availability functionality compared to leading open source database product MySQL, and its built-in asynchronous replication. For master-master database setups, block level replication is more recommended way to build high-availability into the system. Based on thesis research, building high-availability web applications is possible using a combination of open source software and engineering best practices for data protection, availability planning and scaling.

Visualization of communication system testing logs

During the past decades testing has matured from ad-hoc activity into being an integral part of the development process. The benefits of testing are obvious for modern communication systems, which operate in heterogeneous environments amongst devices from various manufacturers. The increased demand for testing also creates demand for tools and technologies that support and automate testing activities. This thesis discusses applicability of visualization techniques in the result analysis part of the testing process. Particularly, the primary focus of this work is visualization of test execution logs produced by a TTCN-3 test system. TTCN-3 is an internationally standardized test specification and implementation language. The TTCN-3 standard suite includes specification of a test logging interface and a graphical presentation format, but no immediate relationship between them. This thesis presents a technique for mapping the log events to the graphical presentation format along with a concrete implementation, which is integrated with the Eclipse Platform and the OpenTTCN Tester toolchain. Results of this work indicate that for majority of the log events, a visual representation may be derived from the TTCN-3 standard suite. The remaining events were analysed and three categories relevant in either log analysis or implementation of the visualization tool were identified: events indicating insertion of something into the incoming queue of a port, events indicating a mismatch and events describing the control flow during the execution. Applicability of the results is limited into the domain of TTCN-3, but the developed mapping and the implementation may be utilized with any TTCN-3 tool that is able to produce the execution log in the standardized XML format.

The role of power relations in strategic supply management – A value net approach

Supplier relationships are key elements of supply management and thus have attracted substantial research interest among academics and practitioners. The collaborative nature of relationships has been the focus of the mainstream research, and limited interest has been channelled towards power in buyer–supplier relationships. However, power is one of the key factors determining the outcomes in many business relations. Hence, one of the main objectives of this dissertation is to clarify how power may influence the nature of buyer–supplier relationships and, moreover, the depth of collaboration. Another main objective is to clarify the role of power relations in strategic supply management. Given the different nature of relationships, the firm needs divergent strategies in its supply management in order to handle them efficiently. Power has been identified as one of the factors that affect the nature of buyer–supplier relationships, and firms should thus develop strategies for handling power relations. Three research questions are addressed in pursuit of these objectives, the aim being to clarify the sources of power, the influence of power on collaboration, and the role of buyer–supplier relationships in the firm’s supply strategy. This dissertation has two parts. The first part provides a synthesis of the overall dissertation, and the second part comprises five complementary research papers. The qualitative research method is applied in an empirical case study from the Finnish food industry. The main contribution of this dissertation is that it clarifies the role of power relations in strategic supply management in value nets, and discloses the nature of power as an influencing factor in supplier relationships. It extends the discussion on power in buyer– supplier relationships in highlighting the context of networks and raising the question of network effects on power relations. It also illustrates how power positions and power relations in value nets can be determined based on the sources of power of the network actors, and shows their influence on collaboration.

Luottamuksen rooli hiljaisen tietämyksen jakamisessa

Pro gradu – tutkielman tavoitteena oli tutkia luottamuksen roolia hiljaisen tietämyksen jakamisessa. Työn teoreettisena tavoitteena oli selvittää luottamuksen tukemisen ja rakentamisen keinoja hiljaisen tietämyksen jakamisen tueksi yhdistämällä hiljaista tietämystä ja luottamusta koskeva kirjallisuus. Empiirisen tutkimuksen tavoitteena oli tuoda teoria käytännön tasolle ja selvittää miten hiljaisen tietämyksen jakamista voidaan edistää luottamuksen avulla. Tässä tutkimuksessa on käytetty menetelmätriangulaatiota empiirisen aineiston tutkimusmenetelmänä yhdistämällä kvalitatiivinen ja kvantitatiivinen tutkimusote. Tutkimusaineisto kerättiin haastattelujen ja kyselyn avulla. Empiirisen tutkimuksen kohteena oli hiljaisen tietämyksen jakaminen tiimikontekstissa ja luottamuksen rooli siinä. Tutkimuksen perusteella saatiin selkeä kuva siitä, mihin hiljaisen tietämyksen jakamisen tekijöihin luottamus vaikuttaa ja millaisia seuraamuksia luottamuksella on hiljaisen tietämyksen jakamiseen. Tutkimuksen tulokset tukivat aiempia empiirisiä tutkimustuloksia tunnepohjaisen ja järkiperäisen luottamuksen osalta. Tässä tutkimuksessa tulokset myös osoittivat, että luottamuksen merkitys tiimin toimintaan, hiljaisen tietämyksen jakamiseen, yhteistyöhön, sitoutumiseen sekä motivaatioon on merkittävä. Tämä on hyvä tiedostaa ja siihen tulee kiinnittää tietoisesti huomiota koko organisaation kehittämisen työkaluna.

Dialogue in the crisis of representation : realism and antirealism in the context of the conversation between theologians and quantum physicists in Göttingen 1949-1961

The aim of this study is to analyse the content of the interdisciplinary conversations in Göttingen between 1949 and 1961. The task is to compare models for describing reality presented by quantum physicists and theologians. Descriptions of reality indifferent disciplines are conditioned by the development of the concept of reality in philosophy, physics and theology. Our basic problem is stated in the question: How is it possible for the intramental image to match the external object?Cartesian knowledge presupposes clear and distinct ideas in the mind prior to observation resulting in a true correspondence between the observed object and the cogitative observing subject. The Kantian synthesis between rationalism and empiricism emphasises an extended character of representation. The human mind is not a passive receiver of external information, but is actively construing intramental representations of external reality in the epistemological process. Heidegger's aim was to reach a more primordial mode of understanding reality than what is possible in the Cartesian Subject-Object distinction. In Heidegger's philosophy, ontology as being-in-the-world is prior to knowledge concerning being. Ontology can be grasped only in the totality of being (Dasein), not only as an object of reflection and perception. According to Bohr, quantum mechanics introduces an irreducible loss in representation, which classically understood is a deficiency in knowledge. The conflicting aspects (particle and wave pictures) in our comprehension of physical reality, cannot be completely accommodated into an entire and coherent model of reality. What Bohr rejects is not realism, but the classical Einsteinian version of it. By the use of complementary descriptions, Bohr tries to save a fundamentally realistic position. The fundamental question in Barthian theology is the problem of God as an object of theological discourse. Dialectics is Barth¿s way to express knowledge of God avoiding a speculative theology and a human-centred religious self-consciousness. In Barthian theology, the human capacity for knowledge, independently of revelation, is insufficient to comprehend the being of God. Our knowledge of God is real knowledge in revelation and our words are made to correspond with the divine reality in an analogy of faith. The point of the Bultmannian demythologising programme was to claim the real existence of God beyond our faculties. We cannot simply define God as a human ideal of existence or a focus of values. The theological programme of Bultmann emphasised the notion that we can talk meaningfully of God only insofar as we have existential experience of his intervention. Common to all these twentieth century philosophical, physical and theological positions, is a form of anti-Cartesianism. Consequently, in regard to their epistemology, they can be labelled antirealist. This common insight also made it possible to find a common meeting point between the different disciplines. In this study, the different standpoints from all three areas and the conversations in Göttingen are analysed in the frameworkof realism/antirealism. One of the first tasks in the Göttingen conversations was to analyse the nature of the likeness between the complementary structures inquantum physics introduced by Niels Bohr and the dialectical forms in the Barthian doctrine of God. The reaction against epistemological Cartesianism, metaphysics of substance and deterministic description of reality was the common point of departure for theologians and physicists in the Göttingen discussions. In his complementarity, Bohr anticipated the crossing of traditional epistemic boundaries and the generalisation of epistemological strategies by introducing interpretative procedures across various disciplines.