Serva ad ministrare : tjänandets ethos i vårdledarskap

Avhandlingen syftar till att ur ett vårdvetenskapligt perspektiv beskriva och upptäcka tjänandets meningsinnehåll samt fördjupa förståelsekunskap om tjänandets ethos i förhållande till vårdledarskap med en inriktning på det vårdadministrativa. Syftet är även att skapa en idealmodell som öppnar för en ny eller annorlunda förståelsehorisont för tjänandets ethos i vårdledarskap. Kunskapssökandet sker genom följande delstudier: (1) I begreppsbestämningen genomförs begreppsanalyser av tjäna och tjänst med avsikt att öppna för en grundförståelse och tankestruktur i forskningsuppgiften. (2) I det idéhistoriska spåras tjänandets ontologiska arv och idémönster fram genom tolkning av historiska källornas texter från 1900-talets första hälft i ljuset av sjuksköterskeledarskap utgående från Sophie Mannerheims, Bertha Wellins och Bergljot Larssons idéer och tankeströmningar. (3) Sökandet fortsätter i dagens kliniska kontextbas genom kvalitativa djupintervjuer med 30 deltagare (vårdledare och vårdare) från Finland, Sverige och Norge. Förförståelsen och forskningens teoretiska perspektiv har rötter i Erikssons caring science-tradition och vårdvetenskapens ontologiska grundantaganden som utvecklats vid Åbo Akademi, Enheten för vårdvetenskap i Vasa. Forskningsansatsen är inspirerad av H-G Gadamers filosofiska hermeneutik. Designen är explorativ-deskriptiv, idiografisk och implicerar ett hypotetisk-deduktivt tillvägagångssätt. Tjänandet och vårdledarskapets ethos upptäcks och tolkas genom det metodologiska närmandet: Erikssons hermeneutiska begreppsbestämningsmodell, idéhistoriska läsakt och hermeneutiska läsakt. Materialet bildar förståelsehorisonter genom den hermeneutiska dialogens successiva och oändliga rörelse. Horisonterna reflekteras mot teorikärnan för att öppna för ny förståelse av tjänandets meningsinnehåll, vårdledarskap och vårdadministration. I slutandet sker en horisontsammansmältning och en reflektiv anslutning till vårdvetenskapens teorikärna som visar hur tjänandets ethos blir evident i vårdledarskap. Resultatet visar att vårdledarskap som är tjänande för patienten och vårdkulturen synliggörs i vårdadministrationens kontext genom huvudets skärpa, handens gärningar och hjärtats visdom. Tjänandets sanna, goda och sköna tidlösa rörelse är riktad mot hälsa och helande. I dag sammankopplas tjänande inom vårdorganisationer med hälsoekonomiska förhållanden, effektivitet, produktivitet och rationalitet, vilket strider mot tjänandets värdegrund, människans värdighet och respekt för livet. Vårdorganisationernas etiska ansvar är att fungera som samhälleliga förebilder, tillrättalägga för vårdadministrationernas tjänande och stå i patientens tjänst. Gestaltningen av tjänandets ethos i vårdledarskap öppnar för nya diskurser, riktningar, visioner och handlingar i den vårdadministrativa verkligheten. Avhandlingen ger vårdvetenskapens systematiska grundforskning ett teoritillskott av fördjupad förståelse av tjänandets och vårdledarskapets historiska och samtida ontologiska evidens och ethos med applikationen på klinisk vårdvetenskap.

Design and evaluation of web interface signs to improve web usability : a semiotic framework

Technological innovations, the development of the internet, and globalization have increased the number and complexity of web applications. As a result, keeping web user interfaces understandable and usable (in terms of ease-of-use, effectiveness, and satisfaction) is a challenge. As part of this, designing userintuitive interface signs (i.e., the small elements of web user interface, e.g., navigational link, command buttons, icons, small images, thumbnails, etc.) is an issue for designers. Interface signs are key elements of web user interfaces because ‘interface signs’ act as a communication artefact to convey web content and system functionality, and because users interact with systems by means of interface signs. In the light of the above, applying semiotic (i.e., the study of signs) concepts on web interface signs will contribute to discover new and important perspectives on web user interface design and evaluation. The thesis mainly focuses on web interface signs and uses the theory of semiotic as a background theory. The underlying aim of this thesis is to provide valuable insights to design and evaluate web user interfaces from a semiotic perspective in order to improve overall web usability. The fundamental research question is formulated as What do practitioners and researchers need to be aware of from a semiotic perspective when designing or evaluating web user interfaces to improve web usability? From a methodological perspective, the thesis follows a design science research (DSR) approach. A systematic literature review and six empirical studies are carried out in this thesis. The empirical studies are carried out with a total of 74 participants in Finland. The steps of a design science research process are followed while the studies were designed and conducted; that includes (a) problem identification and motivation, (b) definition of objectives of a solution, (c) design and development, (d) demonstration, (e) evaluation, and (f) communication. The data is collected using observations in a usability testing lab, by analytical (expert) inspection, with questionnaires, and in structured and semi-structured interviews. User behaviour analysis, qualitative analysis and statistics are used to analyze the study data. The results are summarized as follows and have lead to the following contributions. Firstly, the results present the current status of semiotic research in UI design and evaluation and highlight the importance of considering semiotic concepts in UI design and evaluation. Secondly, the thesis explores interface sign ontologies (i.e., sets of concepts and skills that a user should know to interpret the meaning of interface signs) by providing a set of ontologies used to interpret the meaning of interface signs, and by providing a set of features related to ontology mapping in interpreting the meaning of interface signs. Thirdly, the thesis explores the value of integrating semiotic concepts in usability testing. Fourthly, the thesis proposes a semiotic framework (Semiotic Interface sign Design and Evaluation – SIDE) for interface sign design and evaluation in order to make them intuitive for end users and to improve web usability. The SIDE framework includes a set of determinants and attributes of user-intuitive interface signs, and a set of semiotic heuristics to design and evaluate interface signs. Finally, the thesis assesses (a) the quality of the SIDE framework in terms of performance metrics (e.g., thoroughness, validity, effectiveness, reliability, etc.) and (b) the contributions of the SIDE framework from the evaluators’ perspective.

Cardiac Troponin Specific Autoantibodies: Analytical Tools for Exploring Their Impact on Cardiac Troponin I Testing

Cardiac troponin (cTn) I and T are the recommended biomarkers for the diagnosis and risk stratification of patients with suspected acute coronary syndrome (ACS), a major cause of cardiovascular death and disability worldwide. It has recently been demonstrated that cTn-specific autoantibodies (cTnAAb) can negatively interfere with cTnI detection by immunoassays to the extent that cTnAAb-positive patients may be falsely designated as cTnI-negative. The aim of this thesis was to develop and optimize immunoassays for the detection of both cTnI and cTnAAb, which would eventually enable exploring the clinical impact of these autoantibodies on cTnI testing and subsequent patient management. The extent of cTnAAb interference in different cTnI assay configurations and the molecular characteristics of cTnAAbs were investigated in publications I and II, respectively. The findings showed that cTnI midfragment targeting immunoassays used predominantly in clinical practice are affected by cTnAAb interference which can be circumvented by using a novel 3+1-type assay design with three capture antibodies against the N-terminus, midfragment and C-terminus and one tracer antibody against the C-terminus. The use of this assay configuration was further supported by the epitope specificity study, which showed that although the midfragment is most commonly targeted by cTnAAbs, the interference basically encompasses the whole molecule, and there may be remarkable individual variation at the affected sites. In publications III and IV, all the data obtained in previous studies were utilized to develop an improved version of an existing cTnAAb assay and a sensitive cTnI assay free of this specific analytical interference. The results of the thesis showed that approximately one in 10 patients with suspected ACS have detectable amounts of cTnAAbs in their circulation and that cTnAAbs can inhibit cTnI determination when targeted against the binding sites of assay antibodies used in its immunological detection. In the light of these observations, the risk of clinical misclassification caused by the presence of cTnAAbs remains a valid and reasonable concern. Because the titers, affinities and epitope specificities of cTnAAbs and the concentration of endogenous cTnI determine the final effect of circulating cTnAAbs, appropriately sized studies on their clinical significance are warranted. The new cTnI and cTnAAb assays could serve as analytical tools for establishing the impact of cTnAAbs on cTnI testing and also for unraveling the etiology of cTn-related autoimmune responses.

S960 QC teräksisen I-palkin äärikestävyyden määrittäminen

Tämän työn tavoitteena oli selvittää eurooppalaisen teräsrakenteiden suunniteltustandardin, Eurokoodi 3:n, soveltuvuus ultralujille teräksille. Tällä hetkellä kyseinen standardi pitää sisällään teräslajit vain S700-teräslajiin asti. Tässä kandidaatintyössä selvitettiin S960 QC –teräksisen I-palkin äärikestävyys ja tarkasteltiin nykyisten suunnitteluohjeiden paikkansapitävyyttä.

Show me your brain! Stories of interdisciplinary knowledge creation in practice. Experiences and observations from Aalto Design Factory, Finland.

This dissertation centres on the themes of knowledge creation, interdisciplinarity and knowledge work. My research approaches interdisciplinary knowledge creation (IKC) as practical situated activity. I argue that by approaching IKC from the practice-based perspective makes it possible to “deconstruct” how knowledge creation actually happens, and demystify its strong intellectual, mentalistic and expertise-based connotations. I have rendered the work of the observed knowledge workers into something ordinary, accessible and routinized. Consequently this has made it possible to grasp the pragmatic challenges as well the concrete drivers of such activity. Thus the effective way of organizing such activities becomes a question of organizing and leading effective everyday practices. To achieve that end, I have conducted ethnographic research of one explicitly interdisciplinary space within higher education, Aalto Design Factory in Helsinki, Finland, where I observed how students from different disciplines collaborated in new product development projects. I argue that IKC is a multi-dimensional construct that intertwines a particular way of doing; a way of experiencing; a way of embodied being; and a way of reflecting on the very doing itself. This places emphasis not only the practices themselves, but also on the way the individual experiences the practices, as this directly affects how the individual practices. My findings suggest that in order to effectively organize and execute knowledge creation activities organizations need to better accept and manage the emergent diversity and complexity inherent in such activities. In order to accomplish this, I highlight the importance of understanding and using a variety of (material) objects, the centrality of mundane everyday practices, the acceptance of contradictions and negotiations well as the role of management that is involved and engaged. To succeed in interdisciplinary knowledge creation is to lead not only by example, but also by being very much present in the very everyday practices that make it happen.

Making home rules for mother tongues : the legal implications of linguistic diversity in the design of autonomy regimes

Principen om nationalismen där det politiska och det nationella är samspelt kan vara av markant betydelse för uppbyggande av autonomiska regimer. Likaså tillåter decentralicering och delegering av befogenheter för språk och utbildning (officiellt erkännande av språk, standardisering av språk, undervisningsspråk och relaterade läroplaner) formning av identiteter inom dessa autonomiska regimer. Resultatet är en ofullkomlig cirkulär relation där språk, samfund och politiska institutioner ömsesidigt och kontinuerligt formar varandra: lingvistiskt mångfald prägar och formger autonomiska ordningar och vice-versa. De juridiska implikationerna av territoriella och icke-territoriella former av autonomi är dock av en annan art. Emedan territoriell autonomi bygger på idéen om ett eventuellt inkluderande hemland för lingvistiska grupper, vars vistelseort är avgörande, förstärker den icke-territoriella autonomin idéen om ett exclusivt samfund bestående av själv-identifierade medlemmar som är kapabla till självstyre oavsett territoriella gränser. Denna avhandling utgör an analys av sådana juridiska implikationer genom komparativa och institutionella analyser. Avhandlingen föreslår som resultat en serie av normativa och pragmatiska rekommendationer inriktade på att främja demokratiseringsprocesser i linje med principer om multikulturalism.

Inactivation of Staphylococcus aureus in raw salmon with supercritical CO2 using experimental design

Abstract Considering the microbial safety of consumption of raw foods (Asian food), this study aimed to explore the inactivation S. aureus in raw salmon by supercritical CO2 treatment (SC-CO2). For this purpose, experimental design methodology was employed as a tool to evaluate the effects of pressure (120-220 bar), the depressurization rate (10 to 100 bar.min–1) and the salmon:CO2 mass relation (1:0.2 to 1:1.0). It was observed that the pressure and the depressurization rate was statistically significant, i.e. the higher the system pressure and depressurization rate, the greater the microbial inactivation. The salmon: CO2 mass relation did not influence the S. aureus inactivation in raw salmon. There was a total reduction in S. aureus with 225 bar, a depressurizing rate of 100 bar.min–1, a salmon: CO2 mass relation of 1:0.6, for 2 hours at 33 °C.

Examining human-centered design practice in the mobile apps era

Human-Centered Design (HCD) is a well-recognized approach to the design of interactive computing systems that supports everyday and professional lives of people. To that end, the HCD approach put central emphasis on the explicit understanding of users and context of use by involving users throughout the entire design and development process. With mobile computing, the diversity of users as well as the variety in the spatial, temporal, and social settings of the context of use has notably expanded, which affect the effort of interaction designers to understand users and context of use. The emergence of the mobile apps era in 2008 as a result of structural changes in the mobile industry and the profound enhanced capabilities of mobile devices, further intensify the embeddedness of technology in the daily life of people and the challenges that interaction designers face to cost-efficiently understand users and context of use. Supporting interaction designers in this challenge requires understanding of their existing practice, rationality, and work environment. The main objective of this dissertation is to contribute to interaction design theories by generating understanding on the HCD practice of mobile systems in the mobile apps era, as well as to explain the rationality of interaction designers in attending to users and context of use. To achieve that, a literature study is carried out, followed by a mixed-methods research that combines multiple qualitative interview studies and a quantitative questionnaire study. The dissertation contributes new insights regarding the evolving HCD practice at an important time of transition from stationary computing to mobile computing. Firstly, a gap is identified between interaction design as practiced in research and in the industry regarding the involvement of users in context; whereas the utilization of field evaluations, i.e. in real-life environments, has become more common in academic projects, interaction designers in the industry still rely, by large, on lab evaluations. Secondly, the findings indicate on new aspects that can explain this gap and the rationality of interaction designers in the industry in attending to users and context; essentially, the professional-client relationship was found to inhibit the involvement of users, while the mental distance between practitioners and users as well as the perceived innovativeness of the designed system are suggested in explaining the inclination to study users in situ. Thirdly, the research contributes the first explanatory model on the relation between the organizational context and HCD; essentially, innovation-focused organizational strategies greatly affect the cost-effective usage of data on users and context of use. Last, the findings suggest a change in the nature of HCD in the mobile apps era, at least with universal consumer systems; evidently, the central attention on the explicit understanding of users and context of use shifts from an early requirements phase and continual activities during design and development to follow-up activities. That is, the main effort to understand users is by collecting data on their actual usage of the system, either before or after the system is deployed. The findings inform both researchers and practitioners in interaction design. In particular, the dissertation suggest on action research as a useful approach to support interaction designers and further inform theories on interaction design. With regard to the interaction design practice, the dissertation highlights strategies that encourage a more cost-effective user- and context-informed interaction design process. With the continual embeddedness of computing into people’s life, e.g. with wearable devices and connected car systems, the dissertation provides a timely and valuable view on the evolving humancentered design.

Design, development and assessment of the Java Intelligent Tutoring System

The "Java Intelligent Tutoring System" (JITS) research project focused on designing, constructing, and determining the effectiveness of an Intelligent Tutoring System for beginner Java programming students at the postsecondary level. The participants in this research were students in the School of Applied Computing and Engineering Sciences at Sheridan College. This research involved consistently gathering input from students and instructors using JITS as it developed. The cyclic process involving designing, developing, testing, and refinement was used for the construction of JITS to ensure that it adequately meets the needs of students and instructors. The second objective in this dissertation determined the effectiveness of learning within this environment. The main findings indicate that JITS is a richly interactive ITS that engages students on Java programming problems. JITS is equipped with a sophisticated personalized feedback mechanism that models and supports each student in his/her learning style. The assessment component involved 2 main quantitative experiments to determine the effectiveness of JITS in terms of student performance. In both experiments it was determined that a statistically significant difference was achieved between the control group and the experimental group (i.e., JITS group). The main effect for Test (i.e., pre- and postiest), F( l , 35) == 119.43,p < .001, was qualified by a Test by Group interaction, F( l , 35) == 4.98,p < .05, and a Test by Time interaction, F( l , 35) == 43.82, p < .001. Similar findings were found for the second experiment; Test by Group interaction revealed F( 1 , 92) == 5.36, p < .025. In both experiments the JITS groups outperformed the corresponding control groups at posttest.

Perceptions of creativity in a fashion design course /

Creativity is important to the growth and development of society, to educational institutions, and to the personal growth of individuals. Students who are aware of their creativity are assumed to have innovative ideas and fresh insights. Limited research has been conducted to see if students can identify their own creative abilities. In this study, I explored the students' perceptions and experiences in a fashion design course. This study documented the creative journey from the concept stage of an apparel collection to the final product. Participants were asked to reflect and document their creative moments, describe a creative process, and identify a creative environment. The participants were students who were enrolled in a fashion design course and were asked to participate in this study because they experienced all stages of the design process. Data were collected through personal reflection surveys, focus groups, and personal interviews. Themes of creative moments that emerged from this study were experiences that the participants had as they proceeded through the stages of the fashion design process. All of the participants identified a creative process, but the stages varied for each participant The participants identified themes related to promoting creativity in an environment, including the atmosphere, creative people, teachers, reflection, student needs, and assignments. The participants identified potential barriers in an environment, including rules and guidelines, teachers, the classroom, deadlines and time, feedback, and other important issues. The results ofthis study suggest that there needs to be a better understanding of creativity and greater support and encouragement for creativity in the classroom. Instructors need to support environments that are conducive to creative development and lead to effective learning for students. Students need to learn how to enhance their creativity as well as understand the barriers that block their creative development.

Measuring curriculum integration in the junior grades: the design of an instrument

This study \Alas initiated in response to the Junior Division Review (1985) publ ished by the Ministry of Education for the Province of Ontario. Curriculum integration is an element used within the educational paradigm designed by the Ontario Ministry of Education. It is a term frequent1y verbal ized b>' educators in this province, but because of 1 imi ted resource support regarding this methodology, it was open to broad interpretation resulting in an extreme v ar i at i on i nit simp 1 eme n tat i on • I n de ed, the Min i s try intimated that it was not occurring to any significant degree across the province. The objective of this thes is was· to define integration in the junior classroom and de-:.ign a meas.ur·ement in-:.tr-ument which would in turn high 1 i gh t indicators of curriculum integration. The :.tudy made a prel iminary, field-based survey of educa tiona 1 professionals in order to generate a relevant description of integrated curr-iculum programm i ng as def i ned in the j un i or classroom. The description was a compilation of views expressed by a random selection of teachers, consultants, supervisory officers and principals. The survey revea 1 ed a much more comprehens i ve vi et·<,l of the attributes of integrated programming than tradition would dictate and resulted in a functional definition tha t was broader than past prac t ices. Based on the information generated by this survey, an instrument ou t 1 in i ng program cr iter i a of was devised. an integrated junior cla~·sroom Th i s measuremen t i nstrumen t , designed for all levels of educators, was named uThe Han~.son I nstrumen t for the Measuremen t of Program Integrat ion in the Jun i or Cl assroom". It refl ected five categories intrinsic to the me thodol ogy of integration: Teacher Behaviour, Student Behaviour, Classroom Layout, Cl as~·r oom Environment and Progr amm i ng. Each category and the items therein were successfully tested in val idi ty and rel iabi 1 i ty checKs. Interestingly, the individual class was found to be the major variable programming in in the measuremen t the j un i or d i vis i on • of The integrated instrument demonstrated potential not onl)' a~· an initial measure of the degree of integrated curriculum, but as a guide to strategies to implement such a methodology.

Spreading my wings : how can I improve my practice and contribute to the professional knowledge base through narrative-autobiographical self-study?

"How can I improve my practice and contribute to the professional knowledge base through narrative-autobiographical self-study?" Through the use of Whitehead's (1989) living educational theory and examination of my stories, I identify the values and critical events that have helped me come to know my own learning and shape my professional self. Building on the premise that educational knowledge/theory is created, recreated, and lived through educational inquiry; I strive to make meaning of this data archive, collected over 7 years of teaching. I chart my journey to reexamine my beliefs and practices, to find a balance between traditional and progressive practices and to align my theory and practice. I retell, and, thus, in some way relive, my own "living contradictions." A reconceptualization of the KNOW, DO, BE model (Drake & Burns, 2004) is used to develop strategies to align my practice, including a six-step model of curriculum design that combines the backwards design process of Wiggins and McTighe (1998), the KNOW, DO, BE model (Drake & Burns) and Curry and Samara's (1995) differentiation planner.

Molecular Magnetism: The Design, Synthesis, and Characterization of New Building Blocks for Molecule-based Magnetic Materials

Two classes of building blocks have been prepared and characterized and their coordination chemistry explored working towards the preparation of new molecule-based magnetic materials. In the first project, the amine functionality of 3,3'-diamino-2,2'- bipyridine was exploited for the preparation of a new family of ligands (H2L 1)-(H2L 4). The molecular structures of three ligands have been fully characterized by X-ray crystallography. [molecular structure diagram will not copy here, but is available in full pdf.] The coordination chemistry of these ligands with divalent first row transition metal ions was investigated. For ligand (H2L1), the molecular structures of four coordination complexes with stoichiometries [Zn2(Ll)(OAc)(MeO)]2 (I), [Cu2(L1)(OAc)2 (II), [Li(L1)]3 (III), and [Ni(L1)]3 (IV) were determined by X-ray crystallography. For ligand (H2L2), a Cu(II) complex of stoichiometry [Cu3(L2)(OAc)3MeO] (V) was determined by X-ray crystallography. The magnetic properties of complexes (II), (III), and (V) have been fully elucidated. In project two, synthetic strategies for the preparation of porphyrin molecules bearing triol substituents is presented. Following this approach, three new porphyrin derivatives have been prepared and characterized [Zn(HPTPP-CH2C(CH20H)3)] (VI), [P(TPP)(OCH2C(CH2)H)3)2]+CL- (VII), and [P(OEP)(C6H5)(OCH2C(CH2OH)3)]+Cl- (VIII). Attempts to exchange the labile methoxide bridges of a tetraironIIl single molecule magnet of stoichiometry [Fe4(OMe)6(dpm)6] (Hdpm = dipivaloylmethane) with the triol appended porphyrins will be discussed. [molecular structure diagram will not copy here, but is available in full pdf.]

Construction of I-Deletion-Correcting Ternary Codes

Finding large deletion correcting codes is an important issue in coding theory. Many researchers have studied this topic over the years. Varshamov and Tenegolts constructed the Varshamov-Tenengolts codes (VT codes) and Levenshtein showed the Varshamov-Tenengolts codes are perfect binary one-deletion correcting codes in 1992. Tenegolts constructed T codes to handle the non-binary cases. However the T codes are neither optimal nor perfect, which means some progress can be established. Latterly, Bours showed that perfect deletion-correcting codes have a close relationship with design theory. By this approach, Wang and Yin constructed perfect 5-deletion correcting codes of length 7 for large alphabet size. For our research, we focus on how to extend or combinatorially construct large codes with longer length, few deletions and small but non-binary alphabet especially ternary. After a brief study, we discovered some properties of T codes and produced some large codes by 3 different ways of extending some existing good codes.

I Believe in me, not OCB: Evaluation of Group Function-Based CBT as a Treatment for Obsessive Compulsive Behaviour in Four Children with HFA

Researchers have conceptualized repetitive behaviours in individuals with Autism Spectrum Disorder (ASD) on a continuum oflower-Ievel, motoric, repetitive behaviours and higher-order, repetitive behaviours that include symptoms ofOCD (Hollander, Wang, Braun, & Marsh, 2009). Although obsessional, ritualistic, and stereotyped behaviours are a core feature of ASD, individuals with ASD frequently experience obsessions and compulsions that meet DSM-IV-TR (American Psychiatric Association, 2000) criteria for Obsessive-Compulsive Disorder (OCD). Given the acknowledged difficulty in differentiating between OCD and Autism-related obsessive-compulsive phenomena, the present study uses the term Obsessive Compulsive Behaviour (OCB) to represent both phenomena. This study used a multiple baseline design across behaviours and ABC designs (Cooper, Heron, & Heward, 2007) to investigate if a 9-week Group Function-Based Cognitive Behavioural Therapy (CBT) decreased OCB in four children (ages 7 - 11 years) with High Functioning Autism (HFA). Key treatment components included traditional CBT components (awareness training, cognitive-behavioural skills training, exposure and response prevention) as well as function-based assessment and intervention. Time series data indicated significant decreases in OCBs. Standardized assessments showed decreases in symptom severity, and increases in quality of life for the participants and their families. Issues regarding symptom presentation, assessment, and treatment of a dually diagnosed child are discussed.