Productizing professional marketing services through service blueprinting

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

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

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

Heart rate variability in young adults - Reference values and associations with cardiometabolic risk factors and vascular properties. The Cardiovascular Risk in Young Finns Study.

Background: The function of the autonomic nervous system (ANS) can be evaluated with heart rate variability (HRV). Decreased HRV is associated with aging, the male sex, increased heart rate, and overall increased cardiometabolic risk. It has been hypothesized that early atherosclerotic vascular changes and ANS function are related. Aims: The aims were to assess reference values on HRV in young adults, and examine associations with HRV and cardiometabolic risk factors and metabolic syndrome (MetS) and to study relations between HRV and ultrasonographically measured vascular properties. Participants and methods: The present thesis is part of the Cardiovascular Risk in Young Finns Study. The thesis is based on the follow-up study in 2001, when the study individuals were 24-39 years of age. HRV data were available on 1 956 individuals. Results: HRV was inversely associated with age and heart rate (for all p<0.001). Highfrequency HRV (HF) was higher, and low-frequency HRV (LF) lower in women than men (p<0.0001 for both). MetS was associated with 11% decreased HF and 12% increased LF/HF-ratio in women, and 8% decreased HF and 4% increased LF/HF-ratio in men. Carotid artery distensibility was independently associated with HF and total HRV (for both p<0.05). Conclusions: The reference values in young adults were generated. Decreased HRV was associated with age, the male sex and increased heart rate. Women had higher HF and lower LF variability than men. MetS was related to decrease in HRV. The observed associations between carotid elasticity and HRV, supports the hypothesis that reduction in carotid elasticity may lead to decrease in autonomic cardiac control.

pH titration of native and unfolded ß-trypsin: evaluation of the D D G0 titration and the carboxyl pK values

The stabilizing free energy of ß-trypsin was determined by hydrogen ion titration. In the pH range from 3.0 to 7.0, the change in free energy difference for the stabilization of the native protein relative to the unfolded one (D D G0 titration) was 9.51 ± 0.06 kcal/mol. An isoelectric point of 10.0 was determined, allowing us to calculate the Tanford and Kirkwood electrostatic factor w. This factor presented a nonlinear behavior and indicated more than one type of titratable carboxyl groups in ß-trypsin. In fact, one class of carboxyl group with a pK = 3.91 ± 0.01 and another one with a pK = 4.63 ± 0.03 were also found by hydrogen ion titration of the protein in the folded state

Reference values for lung function tests: I. Static volumes

Static lung volume (LV) measurements have a number of clinical and research applications; however, no previous studies have provided reference values for such tests using a healthy sample of the adult Brazilian population. With this as our main purpose, we prospectively evaluated 100 non-smoking subjects (50 males and 50 females), 20 to 80 years old, randomly selected from more than 8,000 individuals. Gender-specific linear prediction equations were developed by multiple regression analysis with total lung capacity (TLC), functional residual capacity (FRC), residual volume (RV), RV/TLC ratio and inspiratory capacity (IC) as dependent variables, and with age, height, weight, lean body mass and indexes of physical fitness as independent ones. Simpler demographic and anthropometric variables were as useful as more complex measurements in predicting LV values, independent of gender and age (R2 values ranging from 0.49 to 0.78, P<0.001). Interestingly, prediction equations from North American and European studies overestimated the LV at low volumes and underestimated them at high volumes (P<0.05). Our results, therefore, provide a more appropriate frame of reference to evaluate the normalcy of static lung volume values in Brazilian males and females aged 20 to 80 years.

Reference values for lung function tests: II. Maximal respiratory pressures and voluntary ventilation

The strength of the respiratory muscles can be evaluated from static measurements (maximal inspiratory and expiratory pressures, MIP and MEP) or inferred from dynamic maneuvers (maximal voluntary ventilation, MVV). Although these data could be suitable for a number of clinical and research applications, no previous studies have provided reference values for such tests using a healthy, randomly selected sample of the adult Brazilian population. With this main purpose, we prospectively evaluated 100 non-smoking subjects (50 males and 50 females), 20 to 80 years old, selected from more than 8,000 individuals. Gender-specific linear prediction equations for MIP, MEP and MVV were developed by multiple regression analysis: age and, secondarily, anthropometric measurements explained up to 56% of the variability of the dependent variables. The most cited previous studies using either Caucasian or non-Caucasian samples systematically underestimated the observed values of MIP (P<0.05). Interestingly, the self-reported level of regular physical activity and maximum aerobic power correlates strongly with both respiratory and peripheral muscular strength (knee extensor peak torque) (P<0.01). Our results, therefore, provide a new frame of reference to evaluate the normalcy of some useful indexes of respiratory muscle strength in Brazilian males and females aged 20 to 80.

Reference values for lung function tests: III. Carbon monoxide diffusing capacity (transfer factor)

Carbon monoxide diffusing capacity (DLCO) or transfer factor (TLCO) is a particularly useful test of the appropriateness of gas exchange across the lung alveolocapillary membrane. With the purpose of establishing predictive equations for DLCO using a non-smoking sample of the adult Brazilian population, we prospectively evaluated 100 subjects (50 males and 50 females aged 20 to 80 years), randomly selected from more than 8,000 individuals. Gender-specific linear prediction equations were developed by multiple regression analysis with single breath (SB) absolute and volume-corrected (VA) DLCO values as dependent variables. In the prediction equations, age (years) and height (cm) had opposite effects on DLCOSB (ml min-1 mmHg-1), independent of gender (-0.13 (age) + 0.32 (height) - 13.07 in males and -0.075 (age) + 0.18 (height) + 0.20 in females). On the other hand, height had a positive effect on DLCOSB but a negative one on DLCOSB/VA (P<0.01). We found that the predictive values from the most cited studies using predominantly Caucasian samples were significantly different from the actually measured values (P<0.05). Furthermore, oxygen uptake at maximal exercise (VO2max) correlated highly to DLCOSB (R = 0.71, P<0.001); this variable, however, did not maintain an independent role to explain the VO2max variability in the multiple regression analysis (P>0.05). Our results therefore provide an original frame of reference for either DLCOSB or DLCOSB/VA in Brazilian males and females aged 20 to 80 years, obtained from the standardized single-breath technique.

Functional, Social and Emotional Values as Determinants of Environmentally Responsible Media Consumption

The primary purpose of this research is to develop an enhanced understanding of how consumption values influence environmentally responsible consumption of print and digital media. Theoretical elaboration considers the associations of functional, social and emotional consumption values, green consumer segmentation and media consumption. Additionally, the purpose is to identify consumer perceptions of print and digital media’s environmental responsibility. Empirical analysis was based on qualitative interviews with a sample of 20 Finnish consumers categorized in two segments: young adults and middle aged consumers. Primary data collection was conducted through individual, semi-structured interviews. To analyze the respondents’ approach on the topic, the interviews disclosed themes of media consumption, perceived environmental friendliness of media, norms of behavior and consumers’ general consumption patterns. The results implicate functional value dominated the consumption decision-making process both in a general level and in media consumption. In addition to functional value, environmental responsibility does provide consumers with both emotional and social values. Analysis on perceived environmental responsibility of media demonstrated consumers generally perceive digital media as an environmentally responsible alternative because it does not create physical paper waste. Nevertheless, the perceptions of environmental responsibility and media consumption patterns lacked a consistent connection. Though, both theory and empirical results indicated an average consumer lacks a comprehensive understanding of digital and print media’s life-cycle and hence their environmental advantages and disadvantages.

Sotilaspolitiikka Kremlin Olympoksella. Venäjän sotilasreformin diskursiivinen rakentuminen venäläisessä sanomalehdistössä 2008–2012

Tutkimus käsittelee venäläisessä sanomalehdistössä esiintyvää keskustelua Venäjän sotilasreformista. Tutkimuksessa haluttiin selvittää, millaisia diskursseja keskustelussa käytetään sotilasreformin oikeuttamiseksi ja miten ne toimivat vallankäytön välineenä. Tutkimus on monitieteinen. Se antaa vastauksia kielitieteellisessä kehyksessä kielen ja diskurssin roolista päätöksenteossa, yhteiskuntatieteellisessä kehyksessä venäläisestä mediasta ja päätöksentekojärjestelmästä sekä sotatieteellisessä kehyksessä asevoimien kehityksestä ja sotilaspolitiikasta. Tutkimuksen primääriaineisto muodostuu 220 artikkelista, jotka kerättiin yhdeksästä venäläisestä sanomalehdestä vuosien 2008–2012 ajalta. Venäjän johtohenkilöt ja heitä tukevat sanomalehdet oikeuttivat sotilasreformia julkisessa keskustelussa ensisijaisesti viiden syyn avulla: uhkien lisääntymisellä, sodan kuvan muutoksella, asevoimien kalustollisella ja toiminnallisella jälkeenjääneisyydellä, henkilöstön osaamisen alhaisella tasolla ja tarpeella toiminnan järkeistykseen. Sotilasreformin päätöksiä oikeutettiin vetoamalla niiden huolelliseen suunnitteluun, henkilöstön asialliseen kohteluun ja taloudellisten asioiden vakauteen. Sanomalehdistössä esiintyi paljon toisistaan poikkeavia näkemyksiä kehitykseen tarvittavasta suunnasta. Suurin osa kritisoivista diskursseista keskittyi kritisoimaan reformin toteutusta, ei sen olemassaoloa. Kritiikki keskittyi tiedotuksen ja demokraattisen päätöksenteon puutteeseen sekä epäilyksiin reformin valmisteluprosessista. Venäjän asevoimia ja sotilaspolitiikkaa koskevaa uutisointia on ongelmallista tarkastella ilman diskurssikäytäntöjen huomiointia. Venäjän johdon ja sen legitimiteettiä vahvistavien sanomalehtien diskursiivisen vallankäytön tavoitteena on saada Venäjä näyttämään todellisuutta vahvemmalta ja yhtenäisemmältä. Vaikka venäläinen media ja siinä etenkin televisio ei ole vapaata, sanomalehdistö on verrattain hyvä tiedonlähde. Sen varsin monipuolinen omistajuus tutkimusaineiston rajauksen aikana mahdollisti erilaisten näkökulmien esillepääsyn. Analyyttisimmin sotilasreformista uutisoivat ne sanomalehdet, jotka eivät nähneet länsimaita Venäjän uhkana ja representoivat diskursseissaan liberalistisia arvoja kuten avoimuutta ja demokratiaa. Sanomalehdistön vaatimaton rooli venäläisessä mediakentässä heikentää kuitenkin sen vaikuttavuutta yleiseen mielipiteeseen. Sanomalehtien diskurssikäytäntöjen analysointi ideologioiden ja vallankäytön kautta voi tarjota mahdollisuuksia parantaa venäläisen valtionjohdon päätösten ennustettavuutta.

Kallet til livets embete : mødre i helse og lidelse

Mothers represent the natural caring. Natural caring is the object of caring science and of research interest because it establishes the central core of professional caring. In this study, we encounter patients who are mothers in need of care in a psychiatric context. Motherhood involves taking responsibility that extends beyond one's own life, because the child represents possibilities in a yet unknown future. Understanding and knowledge about the mothers' struggle in health and suffering are of crucial importance to enable clinical practice to make provisions for and adapt to the individual patient. The overall purpose of this dissertation is to illuminate how the innermost essence of caring emerges in health and suffering in patients who are mothers in psychiatric care. The purpose of the study in a clinical sense is to seek to understand and illuminate the patient's inner world in health and suffering in terms of contextual, existential, ontological and ethical dimensions. The dissertation is exploratory and descriptive in nature and encompasses induction, deduction and abduction as logics tools of reasoning. A theoretical model of natural caring and a universal theoretical model of the innermost essence of caring is developed as seen from the patient's world in a psychiatric context. The dissertation is anchored in human science's view of the human being and the world and in caring science's perspective. Caring science's view of the human being as a unity comprising body, soul and spirit is central in the study's concept of the patient. This multi-dimensional conception of the human being encompasses the dissertation's basic values and is decisive for choice of methodology. Hermeneutic epistemology guided the interpretation of the empirical data, the paradigmatic theses and assumptions. The dialectical movement in interpretation moves back and forth between empirical data, caring science theory and philosophical theory and reveals deeper insight into meaningful content in the clinical context. The interpretation process comprises four levels of abstraction: rational, contextual, existential and ontological. Hermeneutic philosophy guides the inductive and deductive approach to interpretation, as well as the movement between the clinical context and the caring science paradigm. In this encounter between the visible and invisible reality, the image of natural caring – motherliness emerged. The dissertation consists of four studies. The first study is a systematic review of nineteen research articles. The three other studies are hermeneutical interpretations based on text materials from open interviews. Fifteen participants were interviewed, all of whom are mothers of children between 0 and 18 years of age. All were outpatients in the psychiatric specialist health service. In the interpretation process, the mothers' struggle in health and suffering emerges as a struggle between the inner and outer world. Being a mother and patient in health and suffering in a psychiatric context means to struggle to be oneself, to create oneself, to live and realize one's good deeds as a mother and human being. To be oneself, to possess oneself as a mother is not only a question of tending, playing and learning in order to master a practical situation or to survive. It involves constituting a deep, inner desire to courageously create oneself so that the child is able to realize his or her potential in health and suffering. Motherliness manifests itself in caring as a call to ministering humanity and life. The voice of motherliness is understood as the voice of life—the eternal, inner call of love and freedom. The inner call craves fulfilment. Motherliness in natural caring does not retreat. Motherliness defines the Other as freedom and proceeds without regard for all other exterior requirements to realizing wellbeing. The inner essence of caring is attentive, aware and heeds the call of the heart. The innermost essence of caring is to be and to make oneself responsible for the Other. Responsibility cannot be relinquished; free choice consists in whether or not to follow the call. To renounce the inner call to responsibility is to deny oneself and one's dignity as a human being. The theoretical models provide clinical and systematic caring science with knowledge and understanding based on the natural caring spirit inherent in the human being. The study elucidates and strengthens the ontological basic assumptions about the human being as a unity of body, soul and spirit, the sanctity of the human being and the core of caring, ethos. The results of the dissertation will provide clinical practice with knowledge about the inner movements of the mothers' souls in relation to their responsibility as mothers and human beings. Being able to understand the basic conditions for responsibility is crucial for developing care that encompasses mother and child and the mutual relationship between them. This is basic knowledge for developing attitudes and actions that meet and provide for the needs of the patient as mother and as a whole, suffering human being.

Nurse Competence of Graduating Nursing Students

The competence of graduating nursing students is an important issue in health care as it is related to professional standards, patient safety and the quality of nursing care. Many changes in health care lead to increased demand with respect to nurses’ competence as well the number of nurses. The purpose of this empirical study was to i) describe the nurse competence areas of nursing students in Europe, ii) evaluate the nurse competence of graduating nursing students, iii) identify factors related to the nurse competence, and to iv) assess the congruence between graduating nursing students’ self-assessments and their mentors’ assessments of students’ nurse competence. The study was carried out in two phases: descriptive phase and evaluation phase. The descriptive phase focused on describing the nurse competence areas of nursing students in Europe with the help of a literature review (n=10 empirical studies and n=4 additional documents). Thematic analysis was used as the analysis method. In the evaluation phase, the nurse competence with particular focus on nursing skills of graduating nursing students (n=154) was assessed. In addition, factors related to the nurse competence were examined. Also, the congruence between graduating nursing students’ self-assessments and their mentors’ assessments of students’ nurse competence was evaluated by comparing graduating nursing students’ self-assessments with the assessments by their mentors (n=42) in the final clinical placement in four university hospitals. Descriptive statistics and inferential statistics were used to analyse the data. Based on the results, the nurse competence of nursing students in Europe consists of nine main competence areas: (1) professional/ethical values and practice, (2) nursing skills and interventions, (3) communication and interpersonal skills, (4) knowledge and cognitive ability, (5) assessment and improving quality in nursing, (6) professional development, (7) leadership, management and teamwork, (8) teaching and supervision, and (9) research utilization. Graduating nursing students self-assessed their nurse competence as good. However, when graduating nursing students’ nurse competence was assessed by their mentors, the results were poorer. Readiness for practice based on nurse education, pedagogical atmosphere on the ward, supervisory relationship between student and mentor and being in paid work in health care at the moment of the study were the most significant factors related to the nurse competence. Conclusions: Nurse competence can be evaluated with a scale based on self-assessment, but other evaluation methods could be used alongside to ensure that nurse competence can be completed and evaluated critically. Practical implications are presented for nurse education and nursing practice. In future, longitudinal research is needed in order to understand the development of nurse competence during nurse education and the transition process from a nursing student to a professional nurse.

Indoor NO2 air pollution and lung function of professional cooks

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

Case-Yhtiön Yksikön henkilöstön vaikutusmahdollisuudet työhyvinvoinnin kehittämiseen muutosprosessissa

Työhyvinvointi sisältää työntekijän terveydellisten tekijöiden lisäksi henkisen pääoman näkökulman, joka kattaa työntekijän fyysisen ja psyykkisen hyvinvoinnin, tiedot ja taidot, ammatillisen osaamisen, sekä koulutustaustan. Jotta organisaatiot voisivat menestyä, ja vastata sidosryhmiensä odotuksiin aiempaa tehokkaammin, yksittäisten työntekijöiden tulisi tiedostaa oma roolinsa yritysten liiketoiminnallisten päämäärien saavuttamisessa. Henkilöstön tulee ymmärtää yrityksen strategia ja arvot, sekä oman työnsä merkitys niiden toteuttamisessa. Hyvinvoivassa työyhteisössä vuorovaikutus on avointa, ja jos organisaation henkilöstö ei koe työilmapiiriä tarpeeksi laadukkaaksi, voivat töiden tehokkuus, laatu, sekä tuloksellisuus kärsiä. Tutkimuksen tavoitteena on ollut osallistua työyhteisöiden ympärillä käytävään aktiiviseen keskusteluun, joka käsitteellistää erilaisia työhyvinvoinnin ilmiöitä organisaatioihin ja niiden toimintaympäristöihin kohdistuvissa muutoksissa. Tieteellisten työhyvinvointiin ja organisaatiomuutoksiin kohdistuvien teorioiden lisäksi tutkimuksessa toteutettiin laadullinen kyselytutkimus yksittäisen työntekijän näkökulmasta, ja sen tarkoituksena on ollut tutkia kohdeorganisaation yksikön henkilöstön vaikutusmahdollisuuksia omaan työhyvinvointiinsa. Vastausten kokoamisen, sekä tulosten analysoinnin perusteella voidaan todeta että työhyvinvointi on koko henkilöstön vastuulla työntekijöiden asemasta riippumatta.

Kirkkoherrojen osaamisen johtamisen kehittäminen. Case: Lappeenrannan seurakuntayhtymä

Tässä pro gradu -tutkielmassa tarkastellaan osaamisen johtamista Lappeenrannan seurakuntayhtymässä kirkkoherrojen näkökulmasta. Tutkimuksen tavoitteena on selvittää, miten kirkkoherrojen osaamisen johtamista voidaan kehittää. Tutkielmassa tarkastellaan kirkkoherrojen roolia ja tehtäviä sekä käytössä olevia osaamisen kehittämisen menetelmiä. Lisäksi paneudutaan osaamisen johtamisen haasteisiin ja hengellisen työn erityispiirteisiin. Tutkimus toteutettiin kvalitatiivisena tapaustutkimuksena. Tutkimuksen empiirinen aineisto kerättiin haastattelemalla Lappeenrannan seurakuntayhtymän kaikkia viittä kirkkoherraa. Tutkimuksen tulosten perusteella voidaan havaita, että osaamisen johtaminen ei seurakuntayhtymässä ole kovin suunnitelmallista tai pitkäjänteistä. Tulevaisuuden haasteina nähdään etenkin kirkon yhteiskunnallisen aseman muuttuminen ja jäsenmäärän väheneminen. Suurimpana osaamisen johtamiseen liittyvänä haasteena kirkkoherrat kokevat ajan puutteen. Kirkkoherrojen näkemyksissä omasta roolistaan osaamisen johtamisessa korostuvat kokonaisuuksien hallinta, yleisten suuntaviivojen määrittely ja yhteisen suunnan selkiyttäminen. Osaamisen kehittämisen menetelmiä on käytössä monia, mutta pääpaino on keskusteluissa ja palavereissa sekä koulutuksissa. Hengellisen työn erityispiirteinä nähdään kirkon erityinen arvomaailma sekä uskon henkilökohtainen ja intiimi olemus. Osaaminen tulisi seurakuntayhtymässä ottaa tietoiseksi johtamisen kohteeksi. Kirkkoherrat voivat kehittää omaa osaamisen johtamistaan parantamalla tietoisuutta esimiehen eri rooleista ja tehtäväkentistä. Erityisesti yksilöiden oppimisen tukemiseen ja oppimista edistävän ilmapiirin luomiseen tulisi tulevaisuudessa kiinnittää huomiota. Osaamisen kehittämisen menetelmistä suositeltavia ovat etenkin erilaiset työssä oppimisen keinot.