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.

Asiantuntijuuden hyödyntäminen pk-yritysten hallitustyössä

TIIVISTELMÄ Tekijä: Kirsi Mikkilä Tutkielman nimi: Asiantuntijuuden hyödyntäminen pk-yritysten hallitustyössä Tiedekunta: Kauppatieteellinen tiedekunta Pääaine: Yrittäjyys ja pk-yrityksen johtaminen Vuosi: 2014 Pro gradu -tutkielma: Lappeenrannan teknillinen yliopisto 103 sivua, 9 kuvioa ja 2 liitettä. Tarkastajat: KTT, prof. Timo Pihkala ja KTT, prof. Markku Ikävalko Hakusanat: hallitus, pk-yritys, asiantuntijuus Pk-yrityksen hallitustyö on yksi keskeisimmistä johtamisen välineistä, jonka avulla yritys voi mahdollistaa kasvunsa ja tuottaa omistajien sijoittamalle pääomalle parempaa tuottoa. Tämän tutkimuksen tavoitteena oli tarkastella asiantuntijuuden käyttöä pk-yritysten hallitustyöskentelyssä. Tutkimuksella etsittiin vastauksia kysymyksiin, missä yrityksen kehitysvaiheissa asiantuntijuutta lisätään hallituksessa, mitä sillä halutaan saavuttaa ja miten prosessiin valmistaudutaan. Tavoitteena oli täydentää tietämystä pk-yrityksen hallitustyön muuttumisen ja hallituksen laajenemisen mahdollisuuksista ja syistä. Tutkimus toteutettiin haastattelututkimuksena. Tutkimuksen kohdeorganisaatioiksi valittiin viisi teollisuudenalan koneiden, laitteiden ja tuotteiden toimittajayritystä Päijät-Hämeen alueelta. Tutkimusaineisto kerättiin keväällä 2014 teemahaastatteluina. Tutkimus vahvisti resurssiperustaisen näkökulman nousevan vahvasti esiin pk-yrityksien muutosvaiheista. Hallitustyö ja hallituksen jäsenten osaaminen korostui kasvuhakuisuuden lisääntyessä. Agenttiteoria sai vahvistusta omistajajäsenten valvonnan tarpeen painottuessa ja stewardship -teorian mukaisesti hallitusammattilaiset katsoivat osaamisensa hyödyntämisen olevan palkitsemista tärkeämpää.

Utilization of AMI-Technology in a Multilayered Demand Response Service Environment

This thesis studied the performance of Advanced metering infrastructure systems in a challenging Demand Response environment. The aim was to find out what kind of challenges and bottlenecks could be met when utilizing AMI-systems in challenging Demand Response tasks. To find out the challenges and bottlenecks, a multilayered demand response service concept was formed. The service consists of seven different market layers which consist of Nordic electricity market and the reserve markets of Fingrid. In the simulations the AMI-systems were benchmarked against these seven market layers. It was found out, that the current generation AMI-systems were capable of delivering Demand Response on the most challenging market layers, when observed from time critical viewpoint. Additionally, it was found out, that to enable wide scale Demand Response there are three major challenges to be acknowledged. The challenges hindering the utilization of wide scale Demand Response were related to poor standardization of the systems in use, possible problems in data connectivity solutions and the current electricity market regulation model.

Y-sukupolven johtaminen – odotukset esimiestyöltä

Y-sukupolven oikeantyylinen johtaminen sekä osaamisen hyödyntäminen ja kehittäminen ovat johtamisen haasteena organisaatioissa, jotka toimivat digitaalista osaamista vaativien tuotteiden ja palvelujen parissa. Tämän tutkimuksen tarkoituksena oli tutkia, minkälaisia odotuksia Y-sukupolvella on esimiestyötä ja johtamista kohtaan. Tutkimuksen tavoitteena oli tuottaa tutkimuksen kohdeyrityksen johtamisen kehittämistä varten nuorten työntekijöiden odotukset heihin kohdistuvasta esimiestyöstä. Tutkimuksen tavoitteena oli myös tuottaa tutkittua tietoa Y-sukupolven johtamista koskevaan keskusteluun. Tutkimus oli laadullinen tutkimus, joka toteutettiin haastattelemalla kohdeyrityksen nimeämästä joukosta 12 Y-sukupolven edustajaa. Tutkimusmenetelmänä oli puolistrukturoitu teemahaastattelu. Haastatteluissa kohderyhmään kuuluvat kertoivat omiin mielipiteisiinsä perustuen ajatuksiaan ja odotuksiaan tutkijan määrittämiin teemoihin. Haastatteluteemat olivat: työ ja työn merkitys, kokemukset ja odotukset esimieheen liittyen sekä heidän oman osaamisen hyödyntäminen ja kehittäminen. Tutkimuksen tuloksena havaittiin, että Y-sukupolvi odottaa esimiestyöltä ensisijaisesti johtamista. Esimiehen täytyy pitää organisaatiossa langat käsissään; toimia suunnannäyttäjänä, organisoida ja olla jämäkkä. Esimiehen tulee olla ominaisuuksiltaan kyvyiltään sellainen, jonka johtaminen on selkeää, oikeudenmukaista ja vuorovaikutteista. Y-sukupolvi odottaa selkeitä tavoitteita, oikeudenmukaista ja tasapuolista kohtelua ja palkkaa sekä jatkuvaa palautteeseen ja sparraamiseen liittyvää vuorovaikutusta esimiehen kanssa. Y-sukupolvi odottaa myös, että esimies hyödyntää ja kehittää heidän osaamistaan.

An Update on Inter-Country Differences in Recovery and Utilization of Recycled Paper

The use of recovered paper as raw material in the paper and board industry has increased heavily during recent decades. At the same time, growing environmental awareness has raised the interest in recycling and a more sustainable way of living, at least in high-income countries. This paper combines these topics and explores how economic, demographic and environmental factors have affected the recovery and utilization of recycled paper between 1992 and 2010 in a sample of 70 countries. This study updates and extends the previous research on the topic using panel data and panel data estimation methods. The results confirm the roles of economic determinants but also indicate that concern for the environment impacts the recovery of recycled paper particularly in high-income countries. Moreover, the motives for recycling appear to depend on the income level of a country, which is something that future policies should consider.

Biomass Utilization in PFC Co-firing System with the Slagging and Fouling Analysis

Master’s thesis Biomass Utilization in PFC Co-firing System with the Slagging and Fouling Analysis is the study of the modern technologies of different coal-firing systems: PFC system, FB system and GF system. The biomass co-fired with coal is represented by the research of the company Alstom Power Plant. Based on the back ground of the air pollution, greenhouse effect problems and the national fuel security today, the bioenergy utilization is more and more popular. However, the biomass is promoted to burn to decrease the emission amount of carbon dioxide and other air pollutions, new problems form like slagging and fouling, hot corrosion in the firing systems. Thesis represent the brief overview of different coal-firing systems utilized in the world, and focus on the biomass-coal co-firing in the PFC system. The biomass supply and how the PFC system is running are represented in the thesis. Additionally, the new problems of hot corrosion, slagging and fouling are mentioned. The slagging and fouling problem is simulated by using the software HSC Chemistry 6.1, and the emissions comparison between coal-firing and co-firing are simulated as well.

Liber fostering Open Science and Knowledge Discovery

Presentation of Kristiina Hormia-Poutanen at the 25th Anniversary Conference of The National Repository Library of Finland, Kuopio 22th of May 2015.

Deinking sludge utilization possibilities: technical, economic, and environmental assessments

This report introduces the ENPI project called “EMIR - Exploitation of Municipal and Industrial Residues” which was executed in a co-operation between Lappeenranta University of Technology (LUT), Saint Petersburg State University of Economics (SPbSUE), Saint Petersburg State Technical University of Plant Polymers (SPbSTUPP) and industrial partners from both Leningrad Region (LR), Russia and Finland. The main targets of the research were to identify the possibilities for deinking sludge management scenarios in co-operation with partner companies, to compare the sustainability of the alternatives, and to provide recommendations for the companies in the Leningrad Region on how to best manage deinking sludge. During the literature review, 24 deinking sludge utilization possibilities were identified, the majority falling under material recovery. Furthermore, 11 potential utilizers of deinking sludge were found within the search area determined by the transportation cost. Each potential utilizer was directly contacted in order to establish cooperation for deinking sludge utilization. Finally, four companies, namely, “Finnsementti” – a cement plant in Finland (S1), “St.Gobian Weber” – a light-weight aggregate plant in Finland (S2), “LSR-Cement” – a cement plant in LR (S3), and “Rockwool” – a stone wool plant in LR (S4) were seen as the most promising partners and were included in the economic and environmental assessments. Economic assessment using cost-benefit analysis (CBA) indicated that substitution of heavy fuel oil with dry deinking sludge in S2 was the most feasible option with a benefit/cost ratio (BCR) of 3.6 when all the sludge was utilized. At the same time, the use of 15% of the total sludge amount (the amount that could potentially be treated in the scenario) resulted in a BCR of only 0.16. The use of dry deinking sludge in the production of cement (S3) is a slightly more feasible option with a BCR of 1.1. The use of sludge in stone wool production is feasible only when all the deinking sludge is used and burned in an existing incineration plant. The least economically feasible utilization possibility is the use of sludge in cement production in Finland (S1) due to the high gate fee charged. Environmental assessment was performed applying internationally recognized life cycle assessment (LCA) methodologies: ISO 14040 and ISO 14044. The results of a consequential LCA stated that only S1 and S2 lead to a reduction of all environmental impacts within the impact categories chosen compared to the baseline scenario where deinking sludge is landfilled. Considering S1, the largest reduction of 13% was achieved for the global warming potential (GWP), whereas for S2, the largest decrease of abiotic depletion potential (ADP) was by 1.7%, the eutrophication potential (EP) by 1.8%, and a GWP of 2.1% was documented. In S3, the most notable increase of ADP and acidification potential (AP) by 2.6 and 1.5% was indicated, while the GWP was reduced by 12%, the largest out of all the impact categories. In S4, ADP and AP increased by 2.3 and 2.1% respectively, whereas ODP was reduced by 25%. During LCA, it was noticed that substitution of fuels causes a greater reduction of environmental impact (S1 and S2) than substitution of raw materials (S3 and S4). Despite a number of economically and environmentally acceptable deinking sludge utilization methods being assessed in the research, evaluation of bottlenecks and communications with companies’ representatives uncovered the fact that the availability of the raw materials consumed, and the risks associated with technological problems resulting from the sludge utilization, limited the willingness of industrial partners to start deinking sludge utilization. The research results are of high value for decision-makers at already existing paper mills since the result provide insights regarding alternatives to the deinking sludge utilization possibilities already applied. Thus, the research results support the maximum economic and environmental value recovery from waste paper utilization.

Inadequate utilization of prenatal care in two Brazilian birth cohorts

Data for two birth cohorts from two Brazilian municipalities, Ribeirão Preto in 1994 and São Luís in 1997/1998, were used to identify and compare factors associated with inadequate utilization of prenatal care and to identify factors capable of explaining the differences observed between the two cities. Prenatal care was defined as adequate or inadequate according to the recommendations of the Brazilian Ministry of Health. The chi-square test and Poisson regression were used to compare differences in the inadequacy of prenatal care utilization. The percentage of inadequacy was higher in São Luís (34.6%) than in Ribeirão Preto (16.9%). Practically the same variables were associated with inadequacy in both cities. Puerperae with lower educational level, without a companion or cohabiting, who delivered in public health units, younger than 20 years, multiparae and smokers, with low family income presented higher percentages of inadequate prenatal care utilization. However, the effects of some variables differed between the two cities. The risk for inadequate use of prenatal care was higher for women attended in the public health sector in São Luís and for cohabiting women in Ribeirão Preto. The effect of the remaining factors studied did not differ between cities. The category of admission accounted for 57.0% of the difference in the inadequate use of prenatal care between cities and marital status accounted for 45.3% of the difference. Even after adjustment for all variables, part of the difference in the inadequacy of prenatal care utilization remained unexplained.

The northern provinces of Sweden and Norway with part I, of Russia / published under the superintendence of the Society for the Diffusion of Useful Knowledge.

[N. 1:4400000].

Pienet erikoiskaupat Big datan aikakaudella: Asiakastiedonjohtamisen edellyttämät strategiset orientaatiot.

This master’s thesis has examined how Entrepreneurial, Customer and Knowledge Management Orientations are needed in the use of Big data technology by small retail firms in their Customer Knowledge Management. A vision of the ability of small retailers to move to the Big data era is based on empirical evidence of owner-managers’ attitudes and the firms’ processes. Abductive content analysis was used as a research strategy and the qualitative data was collected through theme interviews of owner-managers of 11 small-size retail firms. The biggest obstacles to the use of Big data by small retail firms are: a lack of information about the new technology; a lack of Knowledge Management Orientation; and, a lack of proactive dimension in Entrepreneurial and Customer Orientations. A strong reactive customer-led orientation, and the ability of the owner-manager to system thinking will support Customer Knowledge Management development. The low stage of technology-use is preventing utilization of customer information. Co-operation between firms or with educational organizations may significantly enhance the use of Big data –technology by small retail firms.

Effect of the Knowledge Representation Form on the Efficiency of Knowledge Sharing

The goal of this thesis is to estimate the effect of the form of knowledge representation on the efficiency of knowledge sharing. The objectives include the design of an experimental framework which would allow to establish this effect, data collection, and statistical analysis of the collected data. The study follows the experimental quantitative design. The experimental questionnaire features three sample forms of knowledge: text, mind maps, concept maps. In the interview, these forms are presented to an interviewee, afterwards the knowledge sharing time and knowledge sharing quality are measured. According to the statistical analysis of 76 interviews, text performs worse in both knowledge sharing time and quality compared to visualized forms of knowledge representation. However, mind maps and concept maps do not differ in knowledge sharing time and quality, since this difference is not statistically significant. Since visualized structured forms of knowledge perform better than unstructured text in knowledge sharing, it is advised for companies to foster the usage of these forms in knowledge sharing processes inside the company. Aside of performance in knowledge sharing, the visualized structured forms are preferable due the possibility of their usage in the system of ontological knowledge management within an enterprise.

The Nature of Object of Perception and Its Role in the Knowledge Concerning the External World

Questions concerning perception are as old as the field of philosophy itself. Using the first-person perspective as a starting point and philosophical documents, the study examines the relationship between knowledge and perception. The problem is that of how one knows what one immediately perceives. The everyday belief that an object of perception is known to be a material object on grounds of perception is demonstrated as unreliable. It is possible that directly perceived sensible particulars are mind-internal images, shapes, sounds, touches, tastes and smells. According to the appearance/reality distinction, the world of perception is the apparent realm, not the real external world. However, the distinction does not necessarily refute the existence of the external world. We have a causal connection with the external world via mind-internal particulars, and therefore we have indirect knowledge about the external world through perceptual experience. The research especially concerns the reasons for George Berkeley’s claim that material things are mind-dependent ideas that really are perceived. The necessity of a perceiver’s own qualities for perceptual experience, such as mind, consciousness, and the brain, supports the causal theory of perception. Finally, it is asked why mind-internal entities are present when perceiving an object. Perception would not directly discern material objects without the presupposition of extra entities located between a perceiver and the external world. Nevertheless, the results show that perception is not sufficient to know what a perceptual object is, and that the existence of appearances is necessary to know that the external world is being perceived. However, the impossibility of matter does not follow from Berkeley’s theory. The main result of the research is that singular knowledge claims about the external world never refer directly and immediately to the objects of the external world. A perceiver’s own qualities affect how perceptual objects appear in a perceptual situation.

Basic life support knowledge of first-year university students from Brazil

We aimed to evaluate knowledge of first aid among new undergraduates and whether it is affected by their chosen course. A questionnaire was developed to assess knowledge of how to activate the Mobile Emergency Attendance Service - MEAS (Serviço de Atendimento Móvel de Urgência; SAMU), recognize a pre-hospital emergency situation and the first aid required for cardiac arrest. The students were also asked about enrolling in a first aid course. Responses were received from 1038 of 1365 (76.04%) new undergraduates. The questionnaires were completed in a 2-week period 1 month after the beginning of classes. Of the 1038 respondents (59.5% studying biological sciences, 11.6% physical sciences, and 28.6% humanities), 58.5% knew how to activate the MEAS/SAMU (54.3% non-biological vs 61.4% biological, P=0.02), with an odds ratio (OR)=1.39 (95%CI=1.07-1.81) regardless of age, sex, origin, having a previous degree or having a relative with cardiac disease. The majority could distinguish emergency from non-emergency situations. When faced with a possible cardiac arrest, 17.7% of the students would perform chest compressions (15.5% non-biological vs 19.1% biological first-year university students, P=0.16) and 65.2% would enroll in a first aid course (51.1% non-biological vs 74.7% biological, P<0.01), with an OR=2.61 (95%CI=1.98-3.44) adjusted for the same confounders. Even though a high percentage of the students recognized emergency situations, a significant proportion did not know the MEAS/SAMU number and only a minority had sufficient basic life support skills to help with cardiac arrest. A significant proportion would not enroll in a first aid course. Biological first-year university students were more prone to enroll in a basic life support course.

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

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