Sickness certification in primary care: a survey on views and practices among Swiss physicians.

QUESTIONS UNDER STUDY: Studies from several countries (Scandinavia, United Kingdom) report that general practitioners (GPs) experience problems in sickness certification. Our study explored views of Swiss GPs towards sickness certification, their practice and experience, professional skills and problematic interactions with patients. METHODS: We conducted an online survey among GPs throughout Switzerland, exploring behaviour of physicians, patients and employers with regard to sickness certification; GPs' views about sickness certification; required competences for certifying sickness absence, and approaches to advance their competence. We piloted the questionnaire and disseminated it through the networks of the five Swiss academic institutes for primary care. RESULTS: We received 507 valid responses (response rate 50%). Only 43/507 GPs experienced sickness certification as problematic per se, yet 155/507 experienced problems in sickness certification at least once a week. The 507 GPs identified estimating a long-term prognosis about work capacity (64%), handling conflicts with patients (54%), and determining the reduction of work capacity (42%) as problematic. Over 75% would welcome special training opportunities, e.g., on sickness certifications during residency (93%), in insurance medicine (81%), and conflict management (80%). CONCLUSION: Sickness certification as such does not present a major problem to Swiss GPs, which contrasts with the experience in Scandinavian countries and in the UK. Swiss GPs did identify specific tasks of sickness certification as problematic. Training opportunities on sick-leave certification and insurance medicine in general were welcomed.

English as a medium of instruction in teaching other languages: attitudes and practices

Internationalisation of HE and emergence of English as a global academic lingua franca used by people who share neither a common native tongue nor cultural and educational background have not only offered more opportunities but also raised challenges. According to recent European surveys, the percentage of pupils attaining the level of independent user in English varies from 14% to 82%, which evidences the potential and the complexity for English as a medium of instruction at tertiary level. This study aims to present the model of foreign language instruction at Vytautas Magnus University where one third of 30 languages are taught through English. It investigates the attitudes and practices of teachers in delivering their English-medium language courses by discussing the questions whether teaching other languages through English is psychologically, culturally and educationally preferable for teachers and students, whether it can limit the content taught and require a special methodology, how the teaching process changes with multiple languages used in the classroom and what level of English is necessary for teachers and students to ensure high quality of English-medium language teaching. The study is based on qualitative methodology with 12 language teachers participating as respondents. The results reveal areas in need of improvement.

Solution marketing characteristics and practices

The first objective of this master's thesis is to find out how the concepts solution and solution marketing are defined in the literature. In order to do so, solution marketing literature is reviewed widely. Another target is to identify the characteristics of solution marketing and to explain how solution marketing can be carried out. The final objective is to determine how well the described solution marketing practices are executed in the target company, and this will be studied with a survey. A solution can be described as a co-created and customized combination of products and services. Solution marketing aims at developing and anticipating customer's business needs and it involves close collaboration between customer and supplier. Solution marketing communication is targeted to a specific audience. It entails deep customer intimacy and is focused on understanding customer's business problem. Solution marketing also requires close collaboration between sales and marketing as well as customer focused mindset. Solution marketing can be executed by promoting thought leadership, presenting solution offering, creating close customer relationships and treating customers as individuals. Solution provider's whole organization must engage customer focus.

Making Sense of Shared Leadership. A case study of leadership processes and practices without formal leadership structure in the team context

Leadership is essential for the effectiveness of the teams and organizations they are part of. The challenges facing organizations today require an exhaustive review of the strategic role of leadership. In this context, it is necessary to explore new types of leadership capable of providing an effective response to new needs. The presentday situations, characterized by complexity and ambiguity, make it difficult for an external leader to perform all leadership functions successfully. Likewise, knowledge-based work requires providing professional groups with sufficient autonomy to perform leadership functions. This study focuses on shared leadership in the team context. Shared leadership is seen as an emergent team property resulting from the distribution of leadership influence across multiple team members. Shared leadership entails sharing power and influence broadly among the team members rather than centralizing it in the hands of a single individual who acts in the clear role of a leader. By identifying the team itself as a key source of influence, this study points to the relational nature of leadership as a social construct where leadership is seen as social process of relating processes that are co-constructed by several team members. Based on recent theoretical developments concerned with relational, practice-based and constructionist approaches to the study of leadership processes, this thesis proposes the study of leadership interactions, working processes and practices to focus on the construction of direction, alignment and commitment. During the research process, critical events, activities, working processes and practices of a case team have been examined and analyzed with the grounded theory –approach in the terms of shared leadership. There are a variety of components to this complex process and a multitude of factors that may influence the development of shared leadership. The study suggests that the development process of shared leadership is a common sense -making process and consists of four overlapping dimensions (individual, social, structural, and developmental) to work with as a team. For shared leadership to emerge, the members of the team must offer leadership services, and the team as a whole must be willing to rely on leadership by multiple team members. For these individual and collective behaviors to occur, the team members must believe that offering influence to and accepting it from fellow team members are welcome and constructive actions. Leadership emerges when people with differing world views use dialogue and collaborative learning to create spaces where a shared common purpose can be achieved while a diversity of perspectives is preserved and valued. This study also suggests that this process can be supported by different kinds of meaning-making and process tools. Leadership, then, does not reside in a person or in a role, but in the social system. The built framework integrates the different dimensions of shared leadership and describes their relationships. This way, the findings of this study can be seen as a contribution to the understanding of what constitutes essential aspects of shared leadership in the team context that can be of theoretical value in terms of advancing the adoption and development process of shared leadership. In the real world, teams and organizations can create conditions to foster and facilitate the process. We should encourage leaders and team members to approach leadership as a collective effort that the team can be prepared for, so that the response is rapid and efficient.

A Case Study of Agile Software Engineering Methods and Practices in the MeeGo Harmattan Open Source and Product Context

The aim of this master’s thesis is to study how Agile method (Scrum) and open source software are utilized to produce software for a flagship product in a complex production environment. The empirical case and the used artefacts are taken from the Nokia MeeGo N9 product program, and from the related software program, called as the Harmattan. The single research case is analysed by using a qualitative method. The Grounded Theory principles are utilized, first, to find out all the related concepts from artefacts. Second, these concepts are analysed, and finally categorized to a core category and six supported categories. The result is formulated as the operation of software practices conceivable in circumstances, where the accountable software development teams and related context accepts a open source software nature as a part of business vision and the whole organization supports the Agile methods.

Mapping the translation needs and practices in development co-operation projects of NGOs

Tämän pro gradu -tutkielman aiheena on kääntäminen ja viestintä vieraalla kielellä Suomen ulkoasiainministeriön rahoittamissa kansalaisjärjestöjen kehitysyhteistyöhankkeissa. Tutkielman on tarkoitus kartoittaa kyseisten kehitysyhteistyöhankkeiden kääntämiseen ja vieraskieliseen viestintään liittyviä tarpeita ja -käytäntöjä. Aihetta ei ole tutkittu laajasti muutoin, joten empiirinen osuus on erityisen merkittävässä roolissa. Tutkielman alussa esitellään ulkoasiainministeriön laatimia suomalaisten kansalaisjärjestöjen kehitysyhteistyöhankkeiden ehtoja ja ohjeita, jotka ovat kyseiselle tutkimukselle olennaisia. Tutkielman teoreettinen osuus koostuu lähinnä metodologisesta pohdinnasta, koska aiempaa tutkimustietoa on vähän. Tutkimusmetodien analysointia on painotettu myös siksi, että empiirisellä osuudella on niin suuri merkitys. Tutkielman empiirinen aineisto on yhtäältä peräisin tutkijan havainnoista, jotka saatiin omia varhaisempia hankehallinnointikokemuksia hyödyntäen sekä osallistuvan havainnoinnin menetelmää käyttäen kahden opiskelijajärjestön kehitysyhteistyöhankkeista vuosien 2009 ja 2012 välisenä aikana. Toisaalta aineisto on kerätty kyselytutkimuksen vastauksista. Kysely lähetettiin 35 suomalaiselle kansalaisjärjestölle, joiden kehitysyhteistyöhankkeita Suomen ulkoasiainministeriö rahoittaa. Järjestöt valittiin satunnaisotannalla. Empiirisen aineiston analyysistä ilmeni muun muassa, että tutkijan alkuperäinen hypoteesi kehitysyhteistyöhön liittyvien tekstien kääntämisen yleisyydestä pitää osittain paikkansa, vaikka tekstejä käännettiinkin kansalaisjärjestöissä vähemmän kuin tutkija odotti. Tutkimusaineisto ei ole kuitenkaan tarpeeksi laaja, jotta tuloksia voitaisiin yleistää, sillä kansalaisjärjestöt, niiden hankkeet, käännöstarpeet ja asiantuntemus osoittautuivat odotetusti hyvin erilaisiksi. Tulokset sisältävät asiaa myös esimerkiksi järjestöissä kääntävien ja vieraalla kielellä viestivien taustoista. Jatkotutkimukset ovat kuitenkin tarpeen, ja mahdollisia tutkimusaiheita on runsaasti.

Drivers and barriers of mobile travel and tourism service adoption : a study of individual perceptions and business model development in a travel and tourism context

The Travel and Tourism field is undergoing changes due to the rapid development of information technology and digital services. Online travel has profoundly changed the way travel and tourism organizations interact with their customers. Mobile technology such as mobile services for pocket devices (e.g. mobile phones) has the potential to take this development even further. Nevertheless, many issues have been highlighted since the early days of mobile services development (e.g. the lack of relevance, ease of use of many services). However, the wide adoption of smartphones and the mobile Internet in many countries as well as the formation of so-called ecosystems between vendors of mobile technology indicate that many of these issues have been overcome. Also when looking at the numbers of downloaded applications related to travel in application stores like Google Play, it seems obvious that mobile travel and tourism services are adopted and used by many individuals. However, as business is expected to start booming in the mobile era, many issues have a tendency to be overlooked. Travelers are generally on the go and thus services that work effectively in mobile settings (e.g. during a trip) are essential. Hence, the individuals’ perceived drivers and barriers to use mobile travel and tourism services in on-site or during trip settings seem particularly valuable to understand; thus this is one primary aim of the thesis. We are, however, also interested in understanding different types of mobile travel service users. Individuals may indeed be very different in their propensity to adopt and use technology based innovations (services). Research is also switching more from investigating issues of mobile service development to understanding individuals’ usage patterns of mobile services. But designing new mobile services may be a complex matter from a service provider perspective. Hence, our secondary aim is to provide insights into drivers and barriers of mobile travel and tourism service development from a holistic business model perspective. To accomplish the research objectives seven different studies have been conducted over a time period from 2002 – 2013. The studies are founded on and contribute to theories within diffusion of innovations, technology acceptance, value creation, user experience and business model development. Several different research methods are utilized: surveys, field and laboratory experiments and action research. The findings suggest that a successful mobile travel and tourism service is a service which supports one or several mobile motives (needs) of individuals such as spontaneous needs, time-critical arrangements, efficiency ambitions, mobility related needs (location features) and entertainment needs. The service could be customized to support travelers’ style of traveling (e.g. organized travel or independent travel) and should be easy to use, especially easy to take into use (access, install and learn) during a trip, without causing security concerns and/or financial risks for the user. In fact, the findings suggest that the most prominent barrier to the use of mobile travel and tourism services during a trip is an individual’s perceived financial cost (entry costs and usage costs). It should, however, be noted that regulations are put in place in the EU regarding data roaming prices between European countries and national telecom operators are starting to see ‘international data subscriptions’ as a sales advantage (e.g. Finnish Sonera provides a data subscription in the Baltic and Nordic region at the same price as in Finland), which will enhance the adoption of mobile travel and tourism services also in international contexts. In order to speed up the adoption rate travel service providers could consider e.g. more local initiatives of free Wi-Fi networks, development of services that can be used, at least to some extent, in an offline mode (do not require costly network access during a trip) and cooperation with telecom operators (e.g. lower usage costs for travelers who use specific mobile services or travel with specific vendors). Furthermore, based on a developed framework for user experience of mobile trip arrangements, the results show that a well-designed mobile site and/or native application, which preferably supports integration with other mobile services, is a must for true mobile presence. In fact, travel service providers who want to build a relationship with their customers need to consider a downloadable native application, but in order to be found through the mobile channel and make contact with potential new customers, a mobile website should be available. Moreover, we have made a first attempt with cluster analysis to identify user categories of mobile services in a travel and tourism context. The following four categories were identified: info-seekers, checkers, bookers and all-rounders. For example “all-rounders”, represented primarily by individuals who use their pocket device for almost any of the investigated mobile travel services, constituted primarily of 23 to 50 year old males with high travel frequency and great online experience. The results also indicate that travel service providers will increasingly become multi-channel providers. To manage multiple online channels, closely integrated and hybrid online platforms for different devices, supporting all steps in a traveler process should be considered. It could be useful for travel service providers to focus more on developing browser-based mobile services (HTML5-solutions) than native applications that work only with specific operating systems and for specific devices. Based on an action research study and utilizing a holistic business model framework called STOF we found that HTML5 as an emerging platform, at least for now, has some limitations regarding the development of the user experience and monetizing the application. In fact, a native application store (e.g. Google Play) may be a key mediator in the adoption of mobile travel and tourism services both from a traveler and a service provider perspective. Moreover, it must be remembered that many device and mobile operating system developers want service providers to specifically create services for their platforms and see native applications as a strategic advantage to sell more devices of a certain kind. The mobile telecom industry has moved into a battle of ecosystems where device makers, developers of operating systems and service developers are to some extent forced to choose their development platforms.

Expectations, frames and practices of genetic counselling in different contexts of genetic testing

Genetic counselling is a process in which the counsellee receives information and support concerning a genetic disease. This study examines the genetic counselling attached to genetic testing. Since genetic information is increasing alongside new testing technologies and the situations faced at the genetic clinics will therefore be more diverse, it is essential to assess what the expectations directed at genetic counselling are. It is also important to compare how they face the current counselling practices. In this study, the expectations, frames and practices of genetic counselling in different contexts of genetic testing were examined from three different perspectives: First, international guidelines covering genetic counselling were analysed to summarise what is expected from genetic counselling and to study how genetic information is framed. Second, national experts in European countries were asked about the regulations and practices of genetic counselling in their country. Finally, ten counsellees who had visited a genetic clinic were interviewed to analyse their expectations and experiences. The counsellees’ perspective was also approached through the background review of the previous studies on counsellees’ experiences. On the basis of the study, there are basic elements that are expected to be covered in genetic counselling from all perspectives. However, the views concerning bioethics, genetic exceptionalism and psychosocial aspects vary depending on the perspective and on the individual situation. Since there are sometimes more differences than similarities between genetic tests, no universal recommendations for counselling can be applied. The practices of genetic counselling should be defined situationally, emphasising the individual needs over the genes.

Conditions and practices in the commercialisation of innovations in wood industry

The report 'Conditions and practices in the commercialisation of innovation in wood industry' has been written as a part of the Wood Academy project. The report analyses the commercialisation conditions and practices of wood industry by utilising product categorisation based on a conceptual schema which combines the aspects of the transfer of the procession of utility and the degree of form/service utility (or value-added) created or provided by the company. Open innovation approaches help to perceive the possible new product and service innovations as well as the new business models and earning logics in the industry. The report also contains brief company cases to demonstrate theory-to-practice and showcase company examples from successful Finnish companies.

Predictors of prejudice perceptions and the role of group identification in international students

The purpose of the present study was first to determine what influences international students' perceptions of prejudice, and secondly to examine how perceptions of prejudice would affect international students' group identification. Variables such as stigma vulnerability and contact which have been previously linked with perceptions of prejudice and intergroup relations were re-examined (Berryman-Fink, 2006; Gilbert, 1998; Nesdale & Todd, 2000), while variables classically linked to prejudicial attitudes such as right-wing authoritarianism and openness to experience were explored in relation to perceptions of prejudice. Furthermore, the study examined how perceptions of prejudice might affect the students' identification choices, by testing two opposing models. The first model was based on the motivational nature of social identity theory (Tajfel & Turner, 1986) while the second model was based on the cognitive nature of self-categorization theory/ rejection-identification model (Turner, Hogg, Oakes, Reicher, & Wetherell, 1987; Schmitt, Spears, & Branscombe,2003). It was hypothesized that stigma vulnerability, right-wing authoritarianism, openness to experience and contact would predict both personal and group perceptions of prejudice. It was also hypothesized that perceptions of prejudice would predict group identification. If the self-categorizationlrejection-identification model was supported, international students would identify with the international students. If the social mobility strategy was supported, international students would identify with the university students group. Participants were 98 international students who filled out questionnaires on the Brock University Psychology Department Website. The first hypothesis was supported. The combination of stigma vulnerability, right-wing authoritarianism, openness to experience and contact predicted both personal and group prejudice perceptions of international students. Furthermore, the analyses supported the self-categorizationlrejectionidentification model. International identification was predicted by the combination of personal and group prejudice perceptions of international students.

An Examination of Youth Perceptions and Understandings of their Experiences with Extrajudicial Sanctions in Relation to Key Principles of the YCJA

It is unclear how the principles of meaningful consequences, fair and proportionate accountability, and rehabilitation and reintegration under the Youth Criminal Justice Act (2003) are understood and experienced by youth participating in diversion from youth court. Interviews with 20 youth revealed that, from their understanding, extrajudicial sanctions were viewed as accomplishing the goals of meaningful consequences and fair and proportionate accountability relatively well, but less emphasis was placed on rehabilitation and reintegration. The findings suggest that there may be a need an examination of the spectrum of responses available to youth under the umbrella of Extrajudicial Sanctions and their ability to achieve the key principles of the legislation. Implications for both youth and policy are addressed.