Strategisen muutoksen johtaminen ongelmayrityksessä - case Osuuskauppa Hämeenmaa

Tavoitteet Tutkielman tavoitteena on selvittää ne tekijät, jotka ratkaisivat lähes konkurssissa olleen vähittäiskaupan yrityksen nostamisen todelliseksi menestystarinaksi. Aineisto ja tutkimusmenetelmä Teoreettinen viitekehys tutkielmassa muodostui keskeisten käsitteiden ympärille liittyneiden artikkeleiden sekä kirjallisuuden tarkastelusta tämän tutkielman kannalta. Empiirinen osa sisälsi tutkimuksen toteuttamisen case-yrityksessä, jossa tutkin strategisen muutoksen johtamista teoreettista viitekehystä hyväksikäyttäen. Tutkimusote tutkielmassa oli kvalitatiivinen ja informaation keräämisen metodina oli teemahaastattelu, mikä mahdollisti runsaan ja monipuolisen aineiston keräämisen case-yrityksestä. Tulokset Tutkimus vahvisti aikaisempia käsityksiä arvojen, vision ja strategian merkityksistä muutoksenjohtamisessa. Arvojen osalta tutkimustuloksessa korostuivat johdon oman esimerkin ja voimakkaan tahtotilan merkitykset arvojen sisäistämisessä. Menestyvän vähittäiskaupan yrityksen strategiaprosessi näyttää olevan monia aikaisempia teorioita suoraviivaisempi prosessi. Myös tietojärjestelmien tuen merkitys tuli esille vahvasti.

A thematic analysis of delusion with religious content in schizophrenia: open, closed, and mixed dynamics

The aim of the present study was to elicit how patients with delusions with religious contents conceptualized or experienced their spirituality and religiousness. Sixty-two patients with present or past religious delusions went through semistructured interviews, which were analyzed using the three coding steps described in the grounded theory. Three major themes were found in religious delusions: ''spiritual identity,'' ''meaning of illness,'' and ''spiritual figures.'' One higher-order concept was found: ''structure of beliefs.'' We identified dynamics that put these personal beliefs into a constant reconstruction through interaction with the world and others (i.e., open dynamics) and conversely structural dynamics that created a complete rupture with the surrounding world and others (i.e., closed structural dynamics); those dynamics may coexist. These analyses may help to identify psychological functions of delusions with religious content and, therefore, to better conceptualize interventions when dealing with it in psychotherapy.

La mise en oeuvre et les mutations d'un problème public : les violences faites aux femmes dans le canton de Genève

Violence against women (VAW) has become an issue for public action and a subject of controversy and debate in the public arena. The occurrences of VAW are - at least in part - reported by public authorities and public policies are designed to combat it, by means of prevention campaigns, setting up of shelters or counselling services. All these measures bring together a range of institutional and non-institutional actors. VAW is furthermore the focus of specific laws, but we know little about the emergence of the regulation of VAW in Switzerland. In this article, we will present preliminary results of the developpment of policies adressing domestic violence in the canton of Geneva, focusing on the political arena and analysing the definitional work done by two associations. These case studies show that the concept of gender violence has been marginalized and replaced by a new understanding of the phenomenon of gender violence, which is presented most often in a symmetrical, psychological and racialized way. Les violences faites aux femmes font l'objet de débats et de controverses et sont désormais un problème public qui réunit une pluralité d'acteurs institutionnels et non institutionnels. Outre diverses législations en la matière, de multiples actions et politiques publiques ont été élaborées dans des contextes variés, sous forme de campagnes de prévention, de création de refuges et de centres de conseils. Dans ce contexte, on ne sait que peu de choses de l'émergence de la régulation de ces violences en Suisse et des diverses formes qu'elle a prises. Cet article présente des résultats provisoires concernant la prise en charge des violences domestiques dans le canton de Genève, en se centrant sur la scène politique et en analysant le travail définitionnel effectué par deux associations hégémoniques dans le domaine. Ces études de cas permettent d'affirmer que le concept de violence de genre a été marginalisé et remplacé par une nouvelle compréhension du phénomène, présentée le plus souvent de façon symétrique, psychologique et racialisée.

Bayesian Networks for the Age Classification of Living Individuals: a Study on Transition Analysis

Over the past few decades, age estimation of living persons has represented a challenging task for many forensic services worldwide. In general, the process for age estimation includes the observation of the degree of maturity reached by some physical attributes, such as dentition or several ossification centers. The estimated chronological age or the probability that an individual belongs to a meaningful class of ages is then obtained from the observed degree of maturity by means of various statistical methods. Among these methods, those developed in a Bayesian framework offer to users the possibility of coherently dealing with the uncertainty associated with age estimation and of assessing in a transparent and logical way the probability that an examined individual is younger or older than a given age threshold. Recently, a Bayesian network for age estimation has been presented in scientific literature; this kind of probabilistic graphical tool may facilitate the use of the probabilistic approach. Probabilities of interest in the network are assigned by means of transition analysis, a statistical parametric model, which links the chronological age and the degree of maturity by means of specific regression models, such as logit or probit models. Since different regression models can be employed in transition analysis, the aim of this paper is to study the influence of the model in the classification of individuals. The analysis was performed using a dataset related to the ossifications status of the medial clavicular epiphysis and results support that the classification of individuals is not dependent on the choice of the regression model.

Services "amis des jeunes": promouvoir des soins adaptés aux adolescents [Youth friendly health services: how to promote quality health care for adolescents].

Beaucoup de jeunes éprouvent des difficultés à demander une aide médicale et psychosociale alors qu'ils en auraient bien besoin. Cela est lié au processus d'autonomisation propre à cette période de la vie : les adolescents souhaitent résoudre leurs problèmes eux-mêmes. Pour améliorer la qualité des soins aux jeunes, l'Organisation mondiale de la santé, avec l'UNICEF et d'autres organismes, a développé le concept de youth friendly health services ; services amis des jeunes. Ce concept repose sur plusieurs principes, comme l'accessibilité, la flexibilité, une formation spécifique du personnel, le respect de la neutralité et de la confidentialité, compétences communicationnelles, etc. L'application de cette approche ne se limite pas aux centres spécialisés en médecine de l'adolescence, mais devra être progressivement implantée dans toutes les structures de soins accueillant des jeunes. Many young people have difficulties requesting medical or psychosocial support, although some badly need it. This difficulty is related to the fact that, as part of their search for autonomy, young people prefer to solve their problems by themselves. To improve the quality of care, the World Health Organization, UNICEF and allied organizations have developed the concept of "Youth friendly health services". This concept includes policies and strategies to improve the accessibility and flexibility, staff's competence and communication skills, etc. Such an approach should not be limited to specialized centers for adolescent health. It should be adopted by all health care institutions dealing with young people.

Extracorporeal liver support in severe alcoholic hepatitis

The severity of alcoholic hepatitis (AH) which may coexist with cirrhosis varies greatly, from asymptomatic forms which are detected in alcoholic patients without any sign of liver disease, except laboratory abnormalities, to severe forms characterised by deep jaundice, ascites, hepatic encephalopathy and low prothrombin index. In hospitalized patients the mortality could be as high as 75%. The elevated number of therapeutic proposals reported for more than forty years reveals the lack of efficacy of a particular modality. Even in the most favorable trials, the survival is already very poor and in some cases related to the development of renal failure or hepatorenal syndrome. There are some motivating reports concerning albumin dialysis as a support treatment in patients with severe AH, either alone or in combination with other pharmacological therapies. The favorable effects of albumin dialysis in patients with severe AH suggest that the procedure used alone or in combination with other therapies may have a role in this clinical condition. This will be particularly relevant to offer an alternative therapy in these patients, thus being a potential bridge to recovery or to be listed for liver transplantation.

Probabilistic graphical models to deal with age estimation of living persons

Due to the rise of criminal, civil and administrative judicial situations involving people lacking valid identity documents, age estimation of living persons has become an important operational procedure for numerous forensic and medicolegal services worldwide. The chronological age of a given person is generally estimated from the observed degree of maturity of some selected physical attributes by means of statistical methods. However, their application in the forensic framework suffers from some conceptual and practical drawbacks, as recently claimed in the specialised literature. The aim of this paper is therefore to offer an alternative solution for overcoming these limits, by reiterating the utility of a probabilistic Bayesian approach for age estimation. This approach allows one to deal in a transparent way with the uncertainty surrounding the age estimation process and to produce all the relevant information in the form of posterior probability distribution about the chronological age of the person under investigation. Furthermore, this probability distribution can also be used for evaluating in a coherent way the possibility that the examined individual is younger or older than a given legal age threshold having a particular legal interest. The main novelty introduced by this work is the development of a probabilistic graphical model, i.e. a Bayesian network, for dealing with the problem at hand. The use of this kind of probabilistic tool can significantly facilitate the application of the proposed methodology: examples are presented based on data related to the ossification status of the medial clavicular epiphysis. The reliability and the advantages of this probabilistic tool are presented and discussed.

Brideshead Revisited (1945) by Evelyn Waugh (1903-1966): the benefit of an Arcadian experience in confronting the human tragedy

As the frontispiece of Book One of Evelyn Waugh’s Brideshead Revisited, the phrase ‘Et in Arcadia ego’ announces the author’s intention of making the classical Arcadian theme a key reference in a text that speaks of nostalgia for a joyful past in times marked by sadness and pain. However, an interpretation may be approached from several directions even within the classical tradition. Thus, without ignoring philological or artistic aspects of the topic, this article focuses on a close study of the author’s most original message: the notion that a youthful Arcadian experience confers on young men and women a ‘residue of happiness’ able to sustain their future development and assist them in dealing with the challenges of personal tragedy.

SQualTrack: A Tool for Robust Fault Detection

One of the techniques used to detect faults in dynamic systems is analytical redundancy. An important difficulty in applying this technique to real systems is dealing with the uncertainties associated with the system itself and with the measurements. In this paper, this uncertainty is taken into account by the use of intervals for the parameters of the model and for the measurements. The method that is proposed in this paper checks the consistency between the system's behavior, obtained from the measurements, and the model's behavior; if they are inconsistent, then there is a fault. The problem of detecting faults is stated as a quantified real constraint satisfaction problem, which can be solved using the modal interval analysis (MIA). MIA is used because it provides powerful tools to extend the calculations over real functions to intervals. To improve the results of the detection of the faults, the simultaneous use of several sliding time windows is proposed. The result of implementing this method is semiqualitative tracking (SQualTrack), a fault-detection tool that is robust in the sense that it does not generate false alarms, i.e., if there are false alarms, they indicate either that the interval model does not represent the system adequately or that the interval measurements do not represent the true values of the variables adequately. SQualTrack is currently being used to detect faults in real processes. Some of these applications using real data have been developed within the European project advanced decision support system for chemical/petrochemical manufacturing processes and are also described in this paper

Reliability of intraoperative ultrasound in margin status assessment in women undergoing breast conserving surgery

Background: Effective treatment for breast cancer requires accurate preoperative planning, developing and implementing a consistent definition of margin clearance, and using tools that provide detailed real-time intraoperative information on margin status. Intraoperative ultrasound (IOUS) may fulfil these requirements and may offer few advantages that other preoperative localization and intraoperative margin assessment techniques may notPurpose: The goal of the present work is to determine how accurate the intraoperative ultrasound should be to acquire complete surgical excision with negative histological margins in patients undergoing Breast Conservative SurgeryDesign: A diagnostic test study with a cross-sectional design carried out in a tertiary referral hospital in Girona within a Breast Pathology UnitParticipants: Women diagnosed with breast cancer undergoing a Breast Conservative Surgery in the Breast Pathology Unit at Hospital Universitari de Girona Dr. Josep Trueta

La motivació al canvi dels agressors de parella que realitzen un programa formatiu: Disseny d’un pla d’intervenció motivacional

En aquesta recerca es presenta el Pla d’Intervenció Motivacional (PIM) per subjectes que han de realitzar un programa formatiu (PF) en matèria de violència domèstica com a mesura penal alternativa. La finalitat principal d’aquest programa motivacional és que els usuaris iniciïn el PF en condicions òptimes per així augmentar l’eficàcia de la mesura i la seva reinserció en la societat. El PIM s’ha fonamentat en els models teòrics sobre motivació al canvi i en les tècniques terapèutiques que resulten més rellevants i eficaces, segons la revisió bibliogràfica exhaustiva feta en la recerca El PIM és un programa d’intervenció individualitzat amb una duració d‘entre 4 i 6 sessions, segons la intensitat de la seva aplicació. El programa vol ajudar als participants a identificar els aspectes positius derivats d’aquest canvi i les seves capacitats personals per aconseguir-lo. Per portar-ho terme, s’utilitza un estil terapèutic basat en el diàleg socràtic mitjançant el qual es treballen els aspectes següents: resolució de l’ambivalència, sentiment d’autoeficàcia, identificació d’objectius específics i desenvolupament d’un pla d’acció alternatiu. Mitjançant l’elaboració dels exercicis i tasques descrits en aquesta memòria, el professional guia a l’usuari per aconseguir augmentar la seva motivació per canviar la conducta problemàtica que ha estat objecte de la imposició de la mesura penal.

La motivación al cambio de los agresores de pareja que realizan un programa formativo: Diseño de un plan de intervención motivacional

En este estudio se presenta el Plan de Intervención Motivacional (PIM) para sujetos que deben realizar un programa formativo (PF) en materia de violencia doméstica como medida penal alternativa. La finalidad principal de este programa motivacional es que los usuarios de medidas penales alternativas inicien el PF en condiciones óptimas para así aumentar la eficacia de la medida y su reinserción en la sociedad. El programa PIM se fundamenta en los modelos teóricos sobre motivación al cambio y en las técnicas terapéuticas que resultan más relevantes y eficaces, según la revisión bibliográfica exhaustiva llevada a cabo en la investigación. El PIM es un programa de intervención individualizada de una duración de entre 4 y 6 sesiones, según la intensidad de su aplicación. El programa tiene como objetivo ayudar a los participantes a identificar los aspectos positivos derivados del cambio y sus capacidades personales para llevarlo a cabo. Para ello, emplea un estilo terapéutico basado en el diálogo socrático mediante el cual se trabajan los aspectos siguientes: resolución de la ambivalencia, sentimiento de auto eficacia, identificación de objetivos específicos y desarrollo de un plan de acción alternativo. Mediante la elaboración de los ejercicios y tareas descritos en esta memoria el profesional guía al usuario para aumentar su motivación para cambiar la conducta problemática objeto de la imposición de la medida penal.

Conversioni al cattolicesimo a Roma tra Sei e Settecento. La presenza degli scandinavi nell’Ospizio dei Convertendi.

In my PhD dissertation, I have examined a group of people of Scandinavian origin received by Ospizio dei Convertendi. This group has been hitherto largely unknown to historical research. The Ospizio was an institute founded by the Oratorian Congregation in Rome in 1673 to provide religious instruction and material aid to both recent and aspirant converts to Roman Catholicism. My research traces the profile of converts and a typology of motives, examining different factors which influenced the conversion process. I show that the key factors were often of a social rather than a religious nature. Moreover, I have analyzed the hospice in the context of Counter-Reformation charity as well. In terms of numbers, the Scandinavians formed a somewhat marginal yet not insignificant group within the Roman hospice. Out of a total of 2203 guests received between 1673 and 1706, 4.6 % were Scandinavians: 74 Swedes (including Finland and Livonia) and 27 Danes (including Norway). They came from a rigorously Protestant region which reacted to Catholicism with severe legislative measures. Converts to Catholicism risked confiscation of their goods, expulsion or even capital punishment. Since both Sweden and Denmark were practically impenetrable to Catholicism at the time and clandestine missionary attempts often failed before they had even properly started, the Roman Catholic Church shifted its interest towards Northerners arriving in Rome, a preferred destination for young noblemen, artists and migrant craftsmen. The material related to Ospizio dei Convertendi, conserved in the Vatican archives, is a scarcely known yet unusually rich source, not only for the religious history of our continent, but also for social history and the study of migration in early modern Europe. It contains a wealth of information about members of the subordinate classes, of their travels and lives in Europe. The profile delineated in these documents is of individuals who had a wide range of different professions and different aspirations. These documents encompass a vast social spectrum that was highly mobile on a continent which by that time had become pluriconfessional. Therefore, these migrants faced the complex religious reality in their everyday life. The principal corpus of my research consists of two types of manuscript sources created for administrative and in a way also for apologetic purposes of the Roman Catholic Church. My starting point is the Primo registro generale of Ospizio dei Convertendi. This is a volume in which the following information about each guest was registered: name, nationality, city of origin, age, sex, profession, confession professed before converting, date of arrival, departure, abjuration and baptism. Typically, the convert was male, originating from Stockholm or Copenhagen, from 21 to 30 years of age. The biggest occupational groups in descending order were soldiers, noblemen, craftsmen and sailors. Thus the data reflects a multiform reality of interurban and long distance migration, ideals regarding the education of young noblemen and gentry as well as the need of European armies to hire foreign mercenaries in their various campaigns. Against this background the almost total absence of women is hardly surprising: there is only one woman in the material I have studied. The second main source, Nota degl’ospiti ricevuti e spese fatte per essi, sheds more light on the choices of the converts, their motivations and their lives outside Scandinavia before reaching Rome. This narrative material permits an analysis which completes but also goes far beyond the columns of the Institute’s general register. This material consists of reports written by Catholic priests based on an interview conducted upon each guest’s arrival. The material frequently includes information on what the converts would do following their departure from the Institute as well. These sources have a specific narrative form and contain short biographies, list reasons for converting and information about the journey from the North to the Mediterranean - a journey which in many cases took several years. Moreover, they show that certain unorthodox practices such as calling on the saints and pleading for help from them were not uncommon in the Protestant popular religion. The recording of information on conversions from Protestantism to Catholicism reflects both religious and social interest on the part of the receiving institute. The information obtained was used for the purposes of religious teaching, for finding adequate ways of inserting the convert into Italian society so that he could earn a living, and to find effective methods to convert others with a similar cultural and geographical background. The stories recorded were based on interviews with the newly-arrived, information obtained from a travel companion or fellow countrymen, or from written documents the aspirant converts carried with them. These sources illustrate, although sometimes in rather simplified ways, the circumstances and motivations which were relevant to the choice of changing one’s confession. In addition, I have examined petitions addressed to the hospice and other Roman authorities in order to get financial aid. These petitions were written by Italian scrittori, and they contain certain conventions and topoi of presenting the conversion with the purpose of improving the chances of obtaining financial aid. It is through these filters, which may seem initially almost invisible, that the remote voice of the converts reaches us. The results of the analysis are particularly interesting because they disagree with some of the principal conclusions of previous work on the subject. First, earlier research has focused almost exclusively on the conversions of noblemen, and has argued, second, that the Queen Christina of Sweden was the driving force behind their change of confession. The sources examined for this dissertation present a profile of long-distance migrants, many of them members of the subordinate classes, who were looking for ways to make their living in Europe. These people had in many cases left their country of origin several years earlier and not for religious reasons, so, crucially, we are not dealing with confessional migration in these cases. Rather, conversion was a complex process, intricately tied up with strategies of survival, integration and upward social mobility. At the same time, while these components are significant on their own right, they do not necessarily point to the absence of motivations of a more clearly religious nature.

O uso da prótese na correção das hérnias da parede abdominal é um avanço, mas o seu uso indiscriminado, um abuso

The objective is to alert the surgeon about the indiscriminate use of synthetic prosthesis in the correction of inguinal and incisional hernias. The authors provide a brief history of surgery on hernias and a review of the literature, showing the importance of classifying inguinal hernias to fit the type of surgical correction with the defect found, abstaining from treating all hernias, with the same type of surgical procedure. In our opinion, small indirect inguinal hernias (type 1 and 2 of Gilbert) and hernias in women must not, in general, be treated with prostheses. The synthetic material should be reserved for direct and large indirect hernias. Even so, this attitude, besides determining a higher cost for the procedure, can lead to important complications such as infection, rejection, fistula formation, chronic pain, alterations in spermatogenesis and the possibility of carcinogenesis, according to more recent reports. The physiology and anatomy of the abdominal wall should be considered when dealing with incisional hernia corrections, where the surgeon can choose among many techniques to correct those defects, and in selected cases, utilize synthetic material. We conclude that although the use of biomaterials has constituted a great advance in surgery for abdominal wall hernia corrections because they decrease recurrences, and permit treatment of large abdominal hernias, the indiscriminate prosthesis usage is an abuse, and it can determine many serious complications, certainly avoidable with a well indicated non mesh technique .

Nuorten KTM-naisten näkemyksiä työmotivaatiosta ja sitoutumisesta palkitsemisen näkökulmasta

Tutkimuksen tavoitteena on selvittää nuorten KTM-naisten näkemyksiä työmotivaatiosta ja sitoutumisesta aineellisen ja aineettoman palkitsemisen näkökulmasta. Tutkimuksen teoreettinen viitekehys pohjautuu työmotivaation osalta klassisiin teorioihin: Maslow’n motivaatioteoriaan, Vroomin odotusarvoteoriaan, Locken päämääräteoriaan, Adamsin oikeudenmukaisuusteoriaan ja Decin sisäisen motivaation teoriaan. Sitoutumisen tarkastelu on jaettu organisaatioon ja työhön sitoutumiseen. Organisaatioon sitoutumista lähestytään Meyerin & Allenin teorian kannalta ja työhön sitoutumista Morrow’n teorian pohjalta. Tarkasteluun on otettu myös Steersin näkemyksiä sitoutumisesta. Palkitsemisen tarkempi määrittely on tehty Kauhasen kokonaispalkitsemisen mallia mukaillen ja se on jaettu aineelliseen ja aineettomaan palkitsemiseen. Tutkimus on luonteeltaan kvalitatiivinen ja tutkimusote deskriptiivinen. Tutkimusongelma ja teoreettinen viitekehys huomioon ottaen, aineistonkeruun menetelmäksi on valittu teemahaastattelu. Tutkimuksessa on haastateltu yhtätoista tutkimuksen kriteerit täyttävää henkilöä. Tutkimustulosten perusteella voidaan todeta, että nuorten KTM-naisten näkemykset työmotivaatiosta ja sitoutumisesta olivat tulkittavissa työn teoreettisen viitekehyksen muodostavien teorioiden valossa. Tutkimustulosten mukaan sekä aineellisen että aineettoman palkitsemisen keinoin voidaan vaikuttaa nuorten KTM-naisten työmotivaatioon ja sitoutumiseen. Palkitsemistapojen vaikutuksessa tutkittaviin ilmiöihin oli havaittavissa selkeä ero. Aineellisen palkitsemisen vaikutus sekä työmotivaatioon että sitoutumiseen koettiin suhteellisen heikoksi. Rahallinen palkitseminen, rahapalkka, koettiin eräänlaisena motivaation perusedellytyksenä, ei varsinaisena motivaatiotekijänä. Poikkeuksena erilaiset bonus- ja kannustinjärjestelmät, joilla koettiin olevan motivoivaa vaikutusta. Aineellisen palkitsemisen vaikutus sitoutumiseen koettiin rajallisena, sillä se vaatii taakseen myös muita keinoja ja tekijöitä. Aineettomalla palkitsemisella sen sijaan havaittiin olevan positiivista vaikutusta sekä työmotivaatioon että sitoutumiseen; joko mo-lempiin yhtä aikaa, vain toiseen tai työmotivaation kautta sitoutumiseen tai päinvastoin. Aineeton palkitseminen koettiin aineellista palkitsemista tukevaksi tai kompensoivaksi tekijäksi. Aineettomat palkitsemiskeinot liittyivät niin työuraan kuin sosiaalisiin palkkioihin. Motivaation osalta aineettomien palkitsemiskeinojen vaikutus koettiin vahvana. Aineetonta palkitsemista pidettiin hyvin sitouttavana, mutta vaikutukseltaan lyhytaikaisena.