Medication competence of nursing students in Finland

Lääkehoidon turvallinen toteuttaminen edellyttää sairaanhoitajalta hyvää lääkehoidon osaamisperustaa. Sairaanhoitajakoulutuksen tehtävänä on mahdollistaa tämän osaamisen kehittyminen. Kansainvälisissä tutkimuksissa on kuitenkin osoitettu, että lääkehoidon opetuksen laajuudessa, sisällössä ja toteutuksessa on vaihtelevuutta. Aikaisemmissa tutkimuksissa on raportoitu myös puutteita lääkehoidon osaamisessa sekä sairaanhoitajilla että sairaanhoitajaopiskelijoilla. Koulutuksen ja lääkehoidon osaamisen kehittämiseksi lääkehoidon opetuksen ja sairaanhoitajaopiskelijoiden lääkehoidon osaamisen monipuolinen arviointi ja osaamista selittävien tekijöiden tarkastelu on tarpeen. Tämän tutkimuksen tarkoituksena oli i) arvioida lääkehoidon opetusta suomalaisessa sairaanhoitajakoulutuksessa, ii) arvioida sairaanhoitajaopiskelijoiden lääkehoidon osaamista sekä iii) tunnistaa sairaanhoitajaopiskelijan lääkehoidon osaamiseen yhteydessä olevat tekijät. Tutkimus toteutettiin kolmessa vaiheessa. Ensimmäisessä vaiheessa kahden integroidun kirjallisuuskatsauksen kautta määriteltiin tutkimuksen kohteena oleva sairaanhoitajan lääkehoidon osaaminen ja aiemmin tunnistetut sairaanhoitajaopiskelijan lääkehoidon osaamiseen yhteydessä olevat tekijät. Toisessa vaiheessa toteutettiin valtakunnallinen lääkehoidon opetukseen liittyvä kysely hoitotyön koulutusohjelmasta vastaaville koulutuspäälliköille (n=22) ja opettajille (n=136). Tutkimuksen kolmannessa vaiheessa opintojensa alku‐ (n=328) ja loppuvaiheessa olevien sairaanhoitajaopiskelijoiden (n=338) lääkehoidon osaaminen arvioitiin ja osaamiseen yhteydessä olevat tekijät tunnistettiin. Aineistojen analyysissä käytettiin pääosin tilastollisia menetelmiä. Tulosten perusteella lääkehoidon opetuksen laajuus vaihteli eri ammattikorkeakouluissa, mutta opetuksen sisältö oli kuitenkin monipuolista. Lisää huomiota tulisi kiinnittää lääkehoidon teoreettiseen perustaan ja itsehoitoon sekä lääkehoidon ohjaukseen liittyviin sisältöalueisiin. Opiskelijoiden lääkehoidon osaamista arvioitiin säännöllisesti kaikissa ammattikorkeakouluissa. Sairaanhoitajaopiskelijan lääkehoidon osaamista arvioitiin tutkimuksessa tietotestillä, lääkelaskentatehtävillä ja lyhyiden potilastapausten ratkaisemisen avulla. Lääkehoidon osaamiseen yhteydessä olevia tekijöitä tarkasteltiin kolmesta näkökulmasta: 1) yksilölliset tekijät, 2) kliiniseen oppimisympäristöön ja 3) ammattikorkeakouluun liittyvät tekijät. Lääkehoidon teoreettista osaamista arvioivassa tietotestissä opiskelijat vastasivat keskimäärin 72 prosenttiin kysymyksistä täysin oikein; lääkelaskuista täysin oikein oli 74 % ja potilastapauksissa 57 % valitsi parhaan mahdollisen toimintatavan. Tulosten perusteella sairaanhoitajaopiskelijan osaamista selittivät eniten yksilölliset tekijät. Lääkehoidon osaamiseen yhteydessä olevien tekijöiden välillä oli eroa opintojen alussa ja lopussa. Opintojen alkuvaiheessa opiskelijan aikaisempi opintomenestys oli yhteydessä lääkehoidon osaamiseen, kun taas opintojen loppuvaiheessa siihen olivat yhteydessä opiskelijan kyky itseohjautuvaan oppimiseen sekä opiskelumotivaatio. Johtopäätöksenä voidaan todeta tutkimuksen tulosten olevan samansuuntaisia kuin aikaisemmissa tutkimuksissa. Lääkehoidon opetuksen laajuus vaihtelee opetussuunnitelmatasolla, mutta täsmällinen arviointi on vaikeaa opetuksen sisältöjen integroimisen takia. Sairaanhoitajaopiskelijoiden lääkehoidon osaaminen oli hieman parempaa kuin aikaisemmissa tutkimuksissa, mutta osaamisessa on edelleen puutteita. Lääkehoidon opetuksen ja osaamisen kehittäminen edellyttää kansallista ja kansainvälistä tutkimus‐ ja kehittämisyhteistyötä. Tutkimuksen tulokset tukevat lääkehoidon opetuksen sekä osaamisen tutkimusta ja kehittämistä.

Management of Customer Co-development in Business-to-Business Markets

Management of customer co-development means involving customers in the development of new products and services, and coordinating the process. In business-tobusiness markets, customer co-development enables the development of innovations that better match customer needs and strengthens customer relationships. However, close collaboration with customers can hamper the innovativeness of new products and lead to overly customized solutions. Therefore, the management of co-development is crucial to its success. Yet the existing research on management of co-development has mainly focused on selecting the right collaboration partners, and the field lacks understanding on how to manage the tensions inherent in customer co-development. The purpose of this thesis is to increase understanding on the management of the codevelopment. The thesis is divided into two parts. The first comprises the literature review and conclusions for the whole study, and the second presents four publications. From the methodological perspective, the research papers follow exploratory qualitative research design. The empirical data comprise interviews with 60 persons, representing 25 different organizations, and a group of 11 end users. The study conceptualizes management of customer co-development in three dimensions 1) relational co-development processes, 2) co-development challenges and paradoxes, and 3) internal customer involvement processes. The findings contribute to the customersupplier relationship, innovation, and marketing management literatures by providing a framework on supplier-customer co-development, addressing co-development paradoxes and their management processes, and suggesting practices for customer involvement. For practitioners, the findings provide tools to manage the challenges related to codevelopment with customers.

Indoor environment and the impact on the health of pre-exisiting asthmatics at work: the development of a risk management framework

This thesis examines the spatial and temporal variation in nitrogen dioxide (NO2) levels in Guernsey and the impacts on pre-existing asthmatics. Whilst air quality in Guernsey is generally good, the levels of NO2 exceed UK standards in several locations. The evidence indicates that people suffering from asthma have exacerbation of their symptoms if exposed to elevated levels of air pollutants including NO2, although this research has never been carried out in Guernsey before. In addition, exposure assessment of individuals is rarely carried out and research in this area is limited due to the complexity of undertaking such a study, which will include a combination of exposures in the home, the workplace and ambient exposures, which vary depending on the individual daily experience. For the first time in Guernsey, this research has examined NO2 levels in correlation with asthma patient admissions to hospital, assessment of NO2 exposures in typical homes and typical workplaces in Guernsey. The data showed a temporal correlation between NO2 levels and the number of hospital admissions and the trend from 2008-2012 was upwards. Statistical analysis of the data did not show a significant linear correlation due to the small size of the data sets. Exposure assessment of individuals showed a spatial variation in exposures in Guernsey and assessment in indoor environments showed that real-time analysis of NO2 levels needs to be undertaken if indoor micro environments for NO2 are the be assessed adequately. There was temporal and spatial variation in NO2 concentrations measured using diffusion tubes, which provide a monthly mean value, and analysers measuring NO2 concentrations in real time. The research shows that building layout and design are important factors for good air flow and ventilation and the dispersion of NO2 indoors. Environmental Health Officers have statutory responsibilities for ambient air quality, hygiene of buildings and workplace environments and this role needs to be co-ordinated with healthcare professionals to improve health outcomes for asthmatics. The outcome of the thesis was the development of a risk management framework for pre-existing asthmatics at work for use by regulators of workplaces and an information leaflet to assist in improving health outcomes for asthmatics in Guernsey.

Status of the beach management units development in Uganda

Fisheries plays a significant and important part in the economy of the country contributing to foreign exchange, food security and employment creation. Lake Victoria contributes over 50% of the total annual fish catch. The purpose of fisheries management is to ensure conservation, protection, proper use, economic efficiency and equitable distribution of the fisheries resources both for the present and future generations through sustainable utilization. The earliest fisheries were mainly at the subsistence level. Fishing gear consisted of locally made basket traps, hooks and seine nets of papyrus. Fishing effort begun to increase with the introduction of more efficient flax gillnets in 1905. Fisheries management in Uganda started in 1914. Before then, the fishery was under some form of traditional management based on the do and don'ts. History shows that the Baganda had strong spiritual beliefs in respect of "god Mukasa" (god of the Lake) and these indirectly contributed to sustainable management of the lake. If a fisherman neglected to comply witt'l any of the ceremonies related to fishing he was expected to encounter a bad omen (Rev. Roscoe, 1965) However, with the introduction of the nylon gill nets, which could catch more fish, traditional management regime broke down. By 1955 the indigenous fish species like Oreochromis variabilis and Oreochromis esculentus had greatly declined in catches. Decline in catches led to introduction of poor fishing methods because of competition for fish. Government in an attempt to regulate the fishing irldustry enacted the first Fisheries Ordinance in 1951 and recruited Fisheries Officers to enforce them. The government put in place minimum net mesh-sizes and Fisheries Officers arrested fishermen without explaining the reason. This led to continued poor fishing practices. The development of government centred management systems led to increased alienation of resource users and to wilful disregard of specific regulations. The realisation of the problems faced by the central management system led to the recognition that user groups need to be actively involved in fisheries management if the systems are to be consistent with sustainable fisheries and be legitimate. Community participation in fisheries management under the Comanagement approach has been adopted in Lake Victoria including other water bodies.

The role of socio-economics in the sustainable development and management of the fisheries

The fisheries resources of Kyoga basin lakes are of greater socio-Economic significance for the poor rural communities of this area. The lake's fisheries provide the much needed animal protein as well as source of income for the fishers and the rural poor communities. Nationally, Kyoga basin lakes fisheries are economically important in that they contribute 27% of the total national fish production. In addition, more than 15 riparian districts depend on it for food and income. Moreover, fish from lakes Kyoga and Kwania playa major role in the regional export commodity trade earning the country foreign exchange. The perception that heavy exploitation of inland fishery resources threatens a loss of socio-economic benefits to local communities and their governments has prompted the new ways of management.

Societal human resources management and development

Based on a broad conceptualization of Human Resources Management and Development (HRMD) as a technical, political, and strategic field concerned to managing and developing people within and towards work context(s), this research aims to explore a potential societal role of Human Resources (HR) profession. Framed on a larger project on “New Human Resources roles”, this particular study approaches HR profession by analysing its macro-societal challenges and intervention spaces.

Individual human resource management and development: career management

Framed on a wider project on Individual Human Resource Management and Development (HRMD), this project aims to explore Individual Career Management and Development (CMD) as an emergent professional field of HRMD.

Development of project management procedures for customer project business

Objective of the thesis is to develop project management procedure for chilled beam projects. In organization is recognized that project management techniques could help in large and complex projects. Information sharing have been challenging in projects, so improvement of information sharing is one key topic of the thesis. Academic researches and literature are used to find suitable project management theories and methods. Main theories are related to phases of the project and project management tools. Practical knowledge of project management is collected from two project business oriented companies. Project management tools are chosen and modified to fulfill needs of the beam projects. Result of the thesis is proposed project management procedure, which includes phases of the chilled beam projects and project milestones. Project management procedure helps to recognize the most critical phases of the project and tools help to manage information of the project. Procedure increases knowledge of the project management techniques and tools. It also forms coherent project management working method among the chilled beam project group.

Development of management accounting practices in energy operations in a forest industry Company

The aim of this master’s thesis was to map the management accounting processes and reporting of an internal service unit. The research was conducted in energy services in a forest industry company. Research questions and the results of the study are highly specific for the case unit although some generalizable features of management accounting in internal service units under shared services were searched. The research was carried out as a qualitative action research and a single case study. Internal benchmarking was used to find best practices from other units and to get a comprehensive understanding of the financial processes of the case company. Empirical data for the study was collected with participant observation, interviews of experts and by exploring internal company documents. A literature review was conducted to outline the subject and to support the study. Although the management accounting processes of the case unit were found to be on a good level, some improvement ideas were presented. Results of the research show that the needs of the customers are in the key role in the processes of an internal service unit. Management accounting and reporting need to support the company strategy and management decision-making. To evaluate the performance of the service unit both financial and non-financial measures are needed.

Current findings from research on professional librarian skills development and needs in Brazil

This paper presents reflections on the outcome of a research project conducted at the School of Communications and Arts of the University of São Paulo, regarding librarian training, their field of expertise and the need for continued education. The methodological design compiled in the research project involved planning-presenting project, and developing the questionnaire for data collection. The electronic form was applied to an intentionally random, stratified sample of 18,374 active librarians throughout Brazil, totalling 3,320 responses that were statistically treated and compiled. Once the data was collected using the electronic forms, we analysed the collected information and the literature, cleansed the information and standardized the bibliographic records and statistical processing of data that formed the results presented in this research project. As the world gets more sophisticated and diversified, the competence required of the professional librarian, which in a first stage is highly technical – remembering that it is impossible to dispose of or move forward without it being well established – grows and includes other important responsibilities in the new organizational environment. We must work towards a holistic qualification, valuing management, methodological, cultural, multidisciplinary and systemic skills – all highlighted in the economy of knowledge.

Government management of tourism in fostering residents support for sustainable tourism development: Evidence from a Portuguese historic town

This study proposes a conceptual framework that explores the correlations between economic dependence (ED), local government management of tourism (GMT), perceived tourism benefits and costs, and support for sustainable tourism development (STD). A quantitative research design was adopted. Data collection was carried out by personal survey applied to 300 residents of the small historic town of Lamego, located within the Douro Valley World Heritage Site. Structural equation modelling methods were employed to analyse the proposed model. Results suggest that GMT has a significant effect on the perceived impacts of tourism, both in the positive and in the negative. The effect of GMT in fostering residents’ support to STD was also empirically supported. Additionally, it was also determined that positive perceptions of the impacts of tourism directly influence support to STD. Nevertheless, ED does not have a significant effect either on perceivedbenefits, nor on perceived costs or on residents’ support to STD. Likewise, perceptions of the negative impacts do not predict residents’ support to STD.

Management and development of enterprise

The research work is devoted to actual problems of development management of industrial enterprises. The general purpose of this work is the choice and justification of rational enterprise development evaluation model and subsequent application of it for assessment of enterprise development level and also forming of recommendations for enterprise management. Theoretical aspects of development management of enterprises were generalized. The approaches to understanding the essence of development enterprise category and its types were considered. It was investigated the evaluation models of enterprise development, their advantages and disadvantages and the difficulties of their implementation. The requirements for formation of the evaluation system of the enterprise development were summarized. It was determined the features of the formation and application of an Index of Enterprise Development. In the empirical part, data about investigated enterprises was collected from their official websites and also complemented with further data from other statistical websites. The analysis was based on the annual financial statements of companies. To assess the level of enterprise development were chosen model proposed by Feshchur and Samulyak (2010). This model involves the calculation of the Index of Enterprise Development using partial indicators, their reference values and weight. It was conducted an analysis of the development of Ukrainian enterprises that produce sauces. OJSC “LZHK” had the highest value of Index of Enterprise Development, in 2013 and 2015, that consisted 0,78 and 0,76 respectively. In 2014 the highest value for the Index belonged to PJSC “Volynholdinh” and amounted 0,74. OJSC “LZHK” had the highest average value of Index of Enterprise Development by the result of 2013-2015 years, and it consisted 0,70. PJSC “Chumak” had the lowest average value of Index of Enterprise Development obtained the result 0,59. In order to raise the enterprise development level, it was suggested to reduce production costs and staff turnover, increase the involvement of employees.

Development of motor competence in childhood and adolescence

This dissertation aimed to investigate the development of motor competence in childhood and adolescence. As a starting point, a systematic review was conducted to investigate the instruments used for the evaluation of motor competence. This review identified a gap in the literature regarding the existence of an instrument to assess motor competence based on the three theoretical constructs (stability, locomotor, manipulative). In an attempt to fill this gap, a valid quantitative instrument was proposed. To meet this purpose, 584 children, between 6 and 14 years of age, were evaluated in nine motor tasks, three for each construct. The final instrument comprised two motor tasks for each construct (stability, locomotor, manipulative) and presented very good fit indexes. This instrument was used to analyse the motor competence behaviour by gender in different age groups, indicating that generally boys outperformed girls and both genders increased their performance across age groups. However, different motor competence growth rates appear in both genders across age groups. In addition, children with high and low motor competence were compared regarding some of their health related fitness variables. We found that, regardless of age and gender, the group with better motor proficiency always showed better results in health related fitness. We found positive moderate to high correlations between motor competence and the variables of cardiovascular fitness and muscular fitness, and an inverse correlation with body composition across the four age groups. We also found that motor competence explained 75% of the variance of the health related fitness for the total sample, with locomotion as the primary predictor. However, when analysing the four age groups, stability skills seem to play an important role in health related fitness in the transition from childhood to adolescence. In conclusion, educational and health policies should consider the development of motor competence as an essential strategy to promote healthy development throughout life.