New and Emerging Challenges of the ICT-Mediated Health and Well-Being Services

This monograph dissertation looks into the field of ICT-mediated health and well-being services. Through six chapters that extend the work done in the reviewed and published articles, the dissertation focuses on new and emerging technologies, and to impact of their use on the beneficiary; the individual who eventually derives advantage from the services. As the field is currently going through major changes particularly in the OECD countries, the focus is on shortterm developments in the field and the analysis on the long term developments is cursory by nature. The dissertation includes theoretical and empirical elements. Most of the empirical elements are linked to product development and conceptualization performed in the national MyWellbeing project that ended in 2010. In the project, the emphasis was on conceptualization of a personal aid for the beneficiary that could be used for managing information and services in the field of health and well-being services. This work continued the theme of developing individual-centric solutions for the field; a work that started in the InnoElli Senior program in 2006. The nature of this thesis is foremost a conceptual elaboration based on a literature review, illustrated in empirical work performed in different projects. As a theoretical contribution, this dissertation elaborates the role of a mediator, i.e. an intermediary, and it is used as an overarching theme. The role acts as a ‘lens’ through which a number of technology-related phenomena are looked at, pinned down and addressed to a degree. This includes introduction of solutions, ranging from anthropomorphic artefacts to decision support systems that may change the way individuals experience clinical encounters in the near-future. Due to the complex and multiform nature of the field, it is impractical and effectively impossible to cover all aspects that are related to mediation in a single work. Issues such as legislation, financing and privacy are all of equal importance. Consideration of all these issues is beyond the scope of this dissertation and their investigation is left to other work. It follows from this that the investigation on the role is not intended as inclusive one. The role of the mediator is also used to highlight some of the ethical issues related to personal health information management, and to mediating health and well-being related issues on behalf of another individual, such as an elderly relative or a fellow member of a small unit in the armed forces. The dissertation concludes in a summary about the use and functions of the mediator, describing some potential avenues for implementing such support mechanisms to the changing field of ICT-mediated health and well-being services. The conclusions also describe some of the limitations of this dissertation, including remarks on methodology and content.

Decision making and decision support in service systems

This thesis is a literature study that develops a conceptual model of decision making and decision support in service systems. The study is related to the Ä-Logi, Intelligent Service Logic for Welfare Sector Services research project, and the objective of the study is to develop the necessary theoretical framework to enable further research based on the research project results and material. The study first examines the concepts of service and service systems, focusing on understanding the characteristics of service systems and their implications for decision making and decision support to provide the basis for the development of the conceptual model. Based on the identified service system characteristics, an integrated model of service systems is proposed that views service systems through a number of interrelated perspectives that each offer different, but complementary, implications on the nature of decision making and the requirements for decision support in service systems. Based on the model, it is proposed that different types of decision making contexts can be identified in service systems that may be dominated by different types of decision making processes and where different types of decision support may be required, depending on the characteristics of the decision making context and its decision making processes. The proposed conceptual model of decision making and decision support in service systems examines the characteristics of decision making contexts and processes in service systems, and their typical requirements for decision support. First, a characterization of different types of decision making contexts in service systems is proposed based on the Cynefin framework and the identified service system characteristics. Second, the nature of decision making processes in service systems is proposed to be dual, with both rational and naturalistic decision making processes existing in service systems, and having an important and complementary role in decision making in service systems. Finally, a characterization of typical requirements for decision support in service systems is proposed that examines the decision support requirements associated with different types of decision making processes in characteristically different types of decision making contexts. It is proposed that decision support for the decision making processes that are based on rational decision making can be based on organizational decision support models, while decision support for the decision making processes that are based on naturalistic decision making should be based on supporting the decision makers’ situation awareness and facilitating the development of their tacit knowledge of the system and its tasks. Based on the proposed conceptual model a further research process is proposed. The study additionally provides a number of new perspectives on the characteristics of service systems, and the nature of decision making and requirements for decision support in service systems that can potentially provide a basis for further discussion and research, and support the practice alike.

Psychopharmacotherapy of panic disorder: 8-week randomized trial with clonazepam and paroxetine

The objective of the present randomized, open-label, naturalistic 8-week study was to compare the efficacy and safety of treatment with clonazepam (N = 63) and paroxetine (N = 57) in patients with panic disorder with or without agoraphobia. Efficacy assessment included number of panic attacks and clinician ratings of the global severity of panic disorders with the clinical global impression (CGI) improvement (CGI-I) and CGI severity (CGI-S) scales. Most patients were females (69.8 and 68.4% in the clonazepam and paroxetine groups, respectively) and age (mean ± SD) was 35.9 ± 9.6 years for the clonazepam group and 33.7 ± 8.8 years for the paroxetine group. Treatment with clonazepam versus paroxetine resulted in fewer weekly panic attacks at week 4 (0.1 vs 0.5, respectively; P < 0.01), and greater clinical improvements at week 8 (CGI-I: 1.6 vs 2.9; P = 0.04). Anxiety severity was significantly reduced with clonazepam versus paroxetine at weeks 1 and 2, with no difference in panic disorder severity. Patients treated with clonazepam had fewer adverse events than patients treated with paroxetine (73 vs 95%; P = 0.001). The most common adverse events were drowsiness/fatigue (57%), memory/concentration difficulties (24%), and sexual dysfunction (11%) in the clonazepam group and drowsiness/fatigue (81%), sexual dysfunction (70%), and nausea/vomiting (61%) in the paroxetine group. This naturalistic study confirms the efficacy and tolerability of clonazepam and paroxetine in the acute treatment of patients with panic disorder.

Lauseen aspektin ilmaiseminen suomen kielessä. Tutkimus olla-, tehdä- ja tulla-verbillisistä tekstilauseista käyttökonteksteissaan

Tutkimuksessa tarkastellaan lauseen aspektin ilmaisemista suomen kielessä. Aspektia käsitellään merkityskategoriana, joka osoittaa lauseen kuvaaman asiaintilan ajallisen keston, ja perustavanlaatuisena aspektuaalisena erontekona pidetään rajattuuden ja rajaamattomuuden vastakohtaisuutta. Tutkimuksessa selvitetään, millä perusteella lauseet saavat joko rajatun tai rajaamattoman aspektitulkinnan ja miten konteksti vaikuttaa tähän tulkintaan. Lauseen kontekstina käsitellään kielellistä kontekstia eli tekstiä. Työ on aineistopohjainen tutkimus kirjoitetusta nykysuomesta, ja tarkastelun kohteena on sanomalehtiteksteistä koottu lauseaineisto. Lauseiden pääverbit ovat olla, tehdä ja tulla. Aineistosta on mahdollista esittää sekä kvalitatiivisia että kvantitatiivisia huomioita. Tutkimuksen teoreettisen ja metodologisen taustan muodostavat eräiden kognitiivisen kielitieteen suuntausten kuvauskäsitteet ja -metodit sekä fennistinen aspektin kuvaamisen perinne. Tutkimuksessa tarkastellaan kahta fennistiikassa esitettyä tapaa määritellä lauseen aspektimerkitys ja osoitetaan, että ne ovat toisiaan täydentäviä. Molemmat lähestymistavat huomioon ottamalla on siis mahdollista kuvata lauseen aspektimerkityksen määräytyminen täsmällisemmin kuin vain yhteen kuvaustapaan keskittymällä. Lisäksi osoitetaan, että keskeisinä aspektin ilmaisemisen keinoina pidetyt keston ja toistuvuuden adverbiaalit jäävät aineistossa marginaalisiksi. Ajankohdan adverbiaaleja puolestaan käsitellään aiemmasta tutkimuksesta poiketen rajattuina tarkastelunäkökulmina kuvattuun asiaintilaan, ja ne toimivat tässä tehtävässä liittyessään aspektiltaan rajaamattomiin lauseisiin. Lisäksi tutkimus osoittaa, että aspektin ilmaisemisen kerroksellisuutta voidaan aspektin ilmaisemiseen osallistuvien lauseenjäsenten kerrostumisen ohella tarkastella lausekokonaisuuden eri semanttisten tasojen kerrostumisena. Lausetta laajemman kontekstin vaikutusta aspektitulkintaan ei ole aiemmin tutkittu suomen kielessä. Tutkimus osoittaa, että aspektiltaan monitulkintaisten lauseiden konteksti voi selventää tulkinnan tai mahdollistaa samanaikaisesti vaihtoehtoiset tulkinnat. Lisäksi erilaisten lauseenulkoisten rajan ilmausten avulla on mahdollista osoittaa lauseen aspektin rajattuutta siinä tapauksessa, että lause muutoin ymmärrettäisiin aspektiltaan rajaamattomaksi.

How Lean Six Sigma and Agile principles optimize ITIL-based processes

Imagine the potential implications of an organization whose business and IT processes are well aligned and are capable of reactively and proactively responding to the external and internal changes. The Philips IT Infrastructure and Operations department (I&O) is undergoing a series of transformation activities to help Philips business keeping up with the changes. I&O would serve a critical function in any business sectors; given that the I&O’s strategy switched from “design, build and run” to “specify, acquire and performance manage”, that function is amplified. In 2013, I&O’s biggest transforming programme I&O Futures engaged multiple interdisciplinary departments and programs on decommissioning legacy processes and restructuring new processes with respect to the Information Technology Internet Library (ITIL), helping I&O to achieve a common infrastructure and operating platform (CI&OP). The author joined I&O Futures in the early 2014 and contributed to the CI&OP release 1, during which a designed model Bing Box and its evaluations were conducted through the lens of six sigma’s structured define-measure-analyze-improve-control (DMAIC) improvement approach. This Bing Box model was intended to firstly combine business and IT principles, namely Lean IT, Agile, ITIL best practices, and Aspect-oriented programming (AOP) into a framework. Secondly, the author implemented the modularized optimization cycles according to the defined framework into Philips’ ITIL-based processes and, subsequently, to enhance business process performance as well as to increase efficiency of the optimization cycles. The unique of this thesis is that the Bing Box model not only provided comprehensive optimization approaches and principles for business process performance, but also integrated and standardized optimization modules for the optimization process itself. The research followed a design research guideline that seek to extend the boundaries of human and organizational capabilities by creating new and innovative artifacts. The Chapter 2 firstly reviewed the current research on Lean Six Sigma, Agile, AOP and ITIL, aiming at identifying the broad conceptual bases for this study. In Chapter 3, we included the process of constructing the Bing Box model. The Chapter 4 described the adoption of Bing Box model: two-implementation case validated by stakeholders through observations and interviews. Chapter 5 contained the concluding remarks, the limitation of this research work and the future research areas. Chapter 6 provided the references used in this thesis.

5th Food Safety and Security Symposium: food and health

Abstract The 5º Simpósio de Segurança Alimentar (5th Food Safety and Security Symposium) was held in May, 2015, in Bento Gonçalves, RS, Brazil with the objective of discussing the interrelation between food and health, in various perspectives. This paper reviews the state of the art regarding all the issues discussed during the Symposium, connecting them with the lectures presented at the conference. As final remarks, it was perceived that the interrelation between food and health is growing stronger and cannot be discussed without involving the different areas involved.

Mudança estrutural, desenvolvimento institucional e crescimento econômico sustentado: um comentário sobre a experiência irlandesa

It is discussed the recent Irish experience of sustained economic growth, in which a social pact, the entry in the European Union and the opening of the economy have all played a paramount role. Some remarks on the sustainability of such an experience are also made.

Using stimulus equivalence to teach monetary skills to school-age children with autism

The present study evaluated the use of stimulus equivalence in teaching monetary skills to school aged children with autism. An AB within-subject design with periodic probes was used. At pretest, three participants demonstrated relation DA, an auditory-visual relation (matching dictated coin values to printed coin prices). Using a three-choice match-to-sample procedure, with a multi-component intervention package, these participants were taught two trained relations, BA (matching coins to printed prices) and CA (matching coin combinations to printed prices). Two participants achieved positive tests of equivalence, and the third participant demonstrated emergent performances with a symmetric and transitive relation. In addition, two participants were able to show generalization of learned skills with a parent, in a second naturalistic setting. The present research replicates and extends the results of previous studies by demonstrating that stimulus equivalence can be used to teach an adaptive skill to children with autism.

The backwoods of our backyards : Ontario pioneers and the crisis of ecology /

Early in his landmark ecocritical book The Comedy of Survival, Joseph Meeker develops an intriguing hypothesis about human behaviour. He remarks the species Homo sapiens tend to behave like an invasive or pioneering organism, entering a bio-geographical region and aggressively outcompeting all other species for space and resources. Moreover, he suggests, human cultural traditions, at least in the West, have reinforced such behaviour, continually insisting that the impulses he describes are both necessary and right. While Meeker's work goes on to assess a number of literary works in both the tragic and comic modes, his work never fully explores this hypothesis in the context of human pioneers; that is, there is no ~xploration o( how these themes manifest themselves within our culture and what role they might play in the culture of specific pioneering groups. This project is an attempt at just such an analysis, examining the validity of Meeker's hypothesis through a case study of settler literature in Upper Canada/Ontario between the . years 1800-1867. It explores Meeker's work within three main areas: first, Chapter Two situates his book historically within the field of ecocriticism, showing what came before and the explosion of ecocritical inquiry that followed its release. This chapter also delves into the rift between the natural sciences and humanities, arguing that a move towards deeper interdisciplinarity is r:tecessary for the future. Chapter Three examines the biological and ecological ground on which Meeker rests his hypothesis through exploring evolutionary biology as well as invasive and pioneer species behaviour. Lastly, Chapter Four examines how these ecological principles are manifested in the writings of early Canadian settlers, suggesting that Meeker's hypothesis indeed finds itself on stable footing.

The impact of hospital downsizing on registered nurses displaced from full-time employment

This research identified and explored the various responses often women Registered Nurses displaced from full-time elnployment as staff nurses in general hospitals in southern Ontario. These nurses were among the hundreds in Ontario who were displaced between October 1991 and October 1995 as a result of organizational downsizing and other health care reform initiatives. The purpose ofthis research was to document tIle responses of nurses to job displacement, and how that experience impacted on a nurse's professional identity and her understanding of the nature and utilization of nursing labour. This study incorporated techniques consistent with the principles of naturalistic inquiry and the narrative tradition. A purposive sample was drawn from the Health Sector Training and Adjustment Program database. Data collection and analysis was a three-step process wherein the data collection in each step was informed by the data analysis in the preceding step. The main technique used for qualitative data collection was semistructured, individual and group interviews. Emerging from the data was a rich and textured story ofhow job displacement disrupted the meaningful connections nurses had with their work. In making meaning of this change, displaced nurses journeyed along a three-step path toward labour adjustment. Structural analysis was the interpretive lens used to view the historical, sociopolitical and ideological forces which constrained the choices reasonably available to displaced nurses while Kelly's personal construct theory was the lens used to view the process of making choices and reconstruing their professional identity.

Beyond g : putting multiple intelligences theory to the test /

The purpose of this study was to investigate Howard Gardner's (1983) Multiple Intelligences theory, which proposes that there are eight independent intelligences: Linguistic, Spatial, Logical/Mathematical, Interpersonal, Intrapersonal, Naturalistic, Bodily-Kinesthetic, and Musical. To explore Gardner's theory, two measures of each ability area were administered to 200 participants. Each participant also completed a measure of general cognitive ability, a personality inventory, an ability self-rating scale, and an ability self-report questionnaire. Nonverbal measures were included for most intelligence domains, and a wide range of content was sampled in Gardner's domains. Results showed that all tests of purely cognitive abilities were significantly correlated with the measure of general cognitive ability, whereas Musical, Bodily-Kinesthetic, and one of the Intrapersonal measures were not. Contrary to what Multiple Intelligences theory would seem to predict, correlations among the tests revealed a positive manifold and factor analysis indicated a large factor of general intelligence, with a mathematical reasoning test and a classification task from the Naturalistic domain having the highest ^- loadings. There were only minor sex differences in performance on the ability tests. Participants' self-estimates of ability were significantly and positively correlated with actual performance in some, but not all, intelligences. With regard to personality, a hypothesized association between Openness to Experience and crystallized intelligence was supported. The implications of the findings in regards to the nature of mental abilities were discussed, and recommendations for further research were made.

Exploratory study : exploring the effectiveness of a literacy-based intervention with children with language impairments

Research points clearly to the need for all concerned stakeholders to adopt a preventative approach while intervening with children who are at-risk for future reading disabilities. Research has indicated also that a particular sub-group of children at-risk for reading impairments include preschool children with language impairments (Catts, 1993). Preschool children with language impairments may have difficulties with emergent literacy skills - important prerequisite skills necessary for successful formal reading. Only in the past decade have researchers begun to study the effects of emergent literacy intervention on preschool children with language impairments. As such, the current study continues this investigation of how to effectively implement an emergent literacy therapy aimed at supporting preschool children with language impairments. In addition to this, the current study explores emergent literacy intervention within an applied clinical setting. The setting, presents a host of methodological and theoretical challenges - challenges that will advance the field of understanding children within naturalistic settings. This exploratory study included thirty-eight participants who were recruited from Speech Services Niagara, a local preschool speech and language program. Using a between-group pre- and posttest design, this study compared two intervention approaches - an experimental emergent literacy intervention and a traditional language intervention. The experimental intervention was adopted from Read It Again! (Justice, McGinty, Beckman, & Kilday, 2006) and the traditional language intervention was based on the traditional models of language therapy typically used in preschool speech and language models across Ontario. 5 Results indicated that the emergent literacy intervention was superior to the ,t..3>~, ~\., ;./h traditional language therapy in improving the children's alphabet knowledge, print and word awareness and phonological awareness. Moreover, results revealed that children with more severe language impairments require greater support and more explicit instruction than children with moderate language impairments. Another important finding indicated that the effects of the preschool emergent literacy intervention used in this study may not be sustainable as children enter grade one. The implications of this study point to the need to support preschool children with language impairments with intensive emergent literacy intervention that extends beyond preschool into formal educational settings.

A Psychosocial Approach to Understanding Causality Assessment in Early Phase Oncology Clinical Trials: A Phenomenological Study

Research Question: What are the psychosocial factors that affect causality assessment in early phase oncology clinical trials? Methods: Thirty-two qualitative interviews were explicated with the aid of “Naturalistic Decision Making”. Data explication consisted of phenomenological reduction, delineating and clustering meaning units, forming themes, and creating a composite summary. Participants were members of the National Cancer Institute of Canada’s Clinical Trial Group Investigative New Drug committee. Results: The process of assigning causality is extremely subjective and full of uncertainty. Physicians had no formal training, nor a tool to assist them with this process. Physicians were apprehensive about their decisions and felt pressure from their patients, as well as the pharmaceutical companies sponsoring the trial. Conclusions: There are many problem areas when attributing causality, all of which have serious consequences, but clinicians used a variety of methods to cope with these problem areas.

Welland Canal Survey of Lands Name Index Page 2

Index of names for the Welland Canal Company's Survey of Land book, 1826. Includes persons name, land cultivated, uncultivated, total land and remarks. The remarks noted include; who surveyed the lands, the dates of the survey, former property names, additional property features etc.The page is titled: Statement of Lands Surveyed and appropriated to the use of the Welland Canal Company.

A Geographical view of the Province of Upper Canada

Full Title: A geographical view of the province of Upper Canada : and promiscuous remarks on the government, in two parts, with an appendix, containing a complete description of the Niagara Falls, and remarks relative to the situation of the inhabitants respecting the war, and a concise history of its progress, to the present date. William and David Robinson, Printers