MARKETING COMMUNICATIONS IN B2B COMPANIES – The Roles of Marketing Communication Tools in the Digital Age

Marketing communications has gone through significant changes during the last decades and new online tools have been leading this change for the last decade. Now, in the digital age, if wanting to be successful companies need to experiment new things and seize the opportunities online provides and adapt to the new environment. However, during this time the marketing communication mix and the meanings given to the various components of it have not changed dramatically, and personal selling, direct marketing, sales promotion, advertising and public relations activities are still regarded as important tools in the marketing communications mix. The purpose of this study was to examine business-to-business marketing communications and the tools used by companies in their marketing communications efforts in the digital age and in a global environment. The research questions dealt with the marketing communication tools and their roles as well as the role of online marketing communication and the way it has shaped the field of b2b marketing communications. In order to answer these questions, qualitative approach was chosen and the data was collected by theme interviews with six representatives of Finnish global companies from the b2b sector being interviewed. The theoretical framework covers the general field of b2b marketing communications and its main elements. The online environment as well as the concept of a global marketplace and integrated approach to marketing communication activities is also discussed. The theory was supported by the interviews regarding the activities and roles of the marketing communication tools and both theory as well as the interviews found personal selling to be a vital tool. However, the importance of online has grown and online marketing activities have risen right next to personal selling. The use of analytics and marketing automation was found to be of great interest in the interviews and they were seen as a growing domain in b2b marketing communications. The importance of targeted and personalised messages from relevant medias was a repeating theme as was the customer-centric approach in marketing communication activities. Also, offline and online tools and channels were seen as something that should be treated together as an entity rather than as separate activities. Relevant content created according to the needs of the customer with the gathered data from analytics were seen as the future of b2b marketing communications. Online has added its input to the more traditionally perceived tools and they are executed within the framework of the digital age. Nevertheless, even though online has increased its presence in the b2b marketing communications mix, the more traditionally perceived marketing communication tools, especially personal selling, have not lost their meaning or place in the b2b marketing communication mix.

Fundraising and investor relations in social enterprise: Marketing your way out of the pioneer gap in African off-grid renewable energy

Social enterprises apply the best of business for the pursuit of social or environmental mission while also generating revenues. Globally, nearly 1,3 billion people lack access to electricity, as well as another billion having access to only low quality and infrequent electricity. Off-grid renewable energy, like solar, will increasingly have a key role in the solution of the energy access issue. The pioneer gap in off-grid renewable energy consists of financing (or funding) gaps and capacity gaps, to do with both the early stage of the enterprises in question, as well as the early stage of the whole industry. The gaps are emphasised by specific characteristics of off-grid renewable energy business models and the requirements of operating in bottom-of-the-pyramid markets. The marketing perspective to fundraising is chosen to uncover the possible role enterprises themselves have in bridging the pioneer gap. The purpose of this thesis is to study how social enterprises operating in off-grid renewable energy in Africa utilise marketing activities in their investor relations in bridging the pioneer gap. This main research question is divided into the following sub-questions:  How does the pioneer gap affect fundraising for these enterprises?  How are the funding needs for these enterprises characterised?  How do these enterprises build trust in their investor relations? The theoretic framework is built on relationship marketing and investor relations, with an emphasis on creation of trust. The research is conducted as a thematical case study. Primary data is gathered via semi-structured interviews with six solar energy companies and two accelerators. According to the findings, the main components affecting trust-creation are diminished information asymmetry and perceived risk, mission alignment as well as a personal fit or relationship with the investor. Therefore, an enterprise can utilise e.g. the following marketing activities in their investor relations to bridge the pioneer gap: ensuring investor material, the enterprise story and presenting of them is clear, concise and complete to “package” the enterprise as an investment; taking investor needs and motivations into account as well as utilising existing investors as ambassadors.

Reinventing the third way : towards new forms of economic and democratic conduct

Avhandlingen studerar samspelet mellan det politiska och det ekonomiska systemet genom det föregående seklet, med speciellt fokus på den nyliberala omdaning som utspelats de senaste tre årtiondena. Med en liberaliserad ekonomi och en individualiserad människa måste också det politiska systemet utformas på ett annat sätt. Gradvisa förändringar har varit synliga, som den växande nätverksorganiseringen, dvs. att olika typer av utvecklingspolitik allt mer genomförs som ett samspel mellan samhällssektorerna, istället för att enbart utföras av den offentliga sektorn som tidigare. Genom fyra fallstudier i Österbotten demonstreras hur arenor för samverkan kan konstrueras i enlighet med vad den aktuella frågan kräver. Ett exempel är det innovationsnätverk som skapats i Karleby-Jakobstad-regionen, där offentliga och privata intressenter deltar, och som samtidigt bryter traditionella administrativa gränser. Ett annat mer negativt exempel är omstruktureringsprocessen i Kaskö-regionen eft er Metsä-Botnia-fabrikens nedläggning, där småkommunproblemet tillsammans med att den privata intressenten inte haft skyldighet att samverka lett till att en tillräckligt regionalt förankrad arena för en långsiktig utvecklingspolitik inte har kunnat skapas. Det här visar på trögheten i det finska systemet, där en stark enhetsstat och en splittrad kommunal nivå ur ett historiskt perspektiv hindrat flexibla anpassningar till samhällsförändringar. Avhandlingen visar att nätverksorganiseringen bör vara en integrerad del av de representativa strukturerna för att kunna påverka processernas utfall. Avhandlingen visar framförallt att deltagande och funktionellt definierade regionala och lokala arenor har stor potential, både ekonomiskt och demokratiskt. Det handlar om att skapa en kultur med aktiverade och engagerade medborgare, vilket står i kontrast till det allt mer passiverande representativa systemet. ---------------------------------------- Väitöskirja tutkii viime vuosisadan poliittisen ja taloudellisen järjestelmän vuorovaikutusta keskittyen erityisesti kolmen viimeisen vuosikymmenen uusliberaaliseen muutokseen. Talouden liberalisoituminen ja ihmisen individualisoituminen edellyttävät myös poliittisen järjestelmän mukautumista. Asteittaisia muutoksia on ollut havaittavissa, kuten kasvava verkosto-organisaatio, toisin sanoen eri alojen kehityspolitiikkaa toteutetaan yhä enemmän eri yhteiskuntasektoreiden vuorovaikutuksena, kun aikaisemmin ainoastaan julkinen sektori vastasi kehityspolitiikan toteuttamisesta. Pohjanmaan maakunnan neljän tapaustutkimuksen avulla osoitetaan, miten vuorovaikutusareena voidaan rakentaa kulloinkin ajankohtaisen asiakokonaisuuden ympärille. Tästä esimerkkinä on Kokkola-Pietarsaari –alueen innovaatioverkosto, johon osallistuvat sekä julkiset että yksityiset sidosryhmät ja joka samalla rikkoo perinteisiä hallinnollisia rajoja. Toinen, kielteisempi esimerkki on Kaskisten alueen rakennemu utosprosessi Metsä-Botnian tehtaan sulkemisen jälkeen. Siellä pienkuntaongelma yhdistettynä siihen, että yksityinen sidosryhmä ei ole ollut velvollinen tekemään yhteistyötä, on johtanut siihen, että ei ole kyetty luomaan alueen pitkäaikaiseen kehittämiseen sitoutunutta vuorovaikutusareenaa. Tämä osoittaa suomalaisen järjestelmän kankeuden, jossa historiallisesta näkökulmasta vahva yhtenäinen valtio ja hajanainen kuntataso estävät joustavan yhteiskuntamuutoksiin sopeutumisen. Väitöskirja osoittaa, että verkosto-organisaation on oltava yhteiskunnassa vaikuttaviin rakenteisiin integroitu osa, jotta se voi vaikuttaa prosessien tuloksiin. Väitöskirja osoittaa ennen kaikkea, että osallistuvilla ja toiminnallisesti määritellyillä alueellisilla ja paikallisilla areenoilla on suuri taloudellinen ja demokraattinen potentiaali. Passivoivan edustavan järjestelmän tilalle on luotava aktiivisten ja tavoitteisiin sitoutuneiden kansalaisten vuorovaikutusjärjestelmä.

Cytoadhesion of Plasmodium falciparum-infected erythrocytes and the infected placenta: a two-way pathway

Malaria is undoubtedly the world's most devastating parasitic disease, affecting 300 to 500 million people every year. Some cases of Plasmodium falciparum infection progress to the deadly forms of the disease responsible for 1 to 3 million deaths annually. P. falciparum-infected erythrocytes adhere to host receptors in the deep microvasculature of several organs. The cytoadhesion of infected erythrocytes to placental syncytiotrophoblast receptors leads to pregnancy-associated malaria (PAM). This specific maternal-fetal syndrome causes maternal anemia, low birth weight and the death of 62,000 to 363,000 infants per year in sub-Saharan Africa, and thus has a poor outcome for both mother and fetus. However, PAM and non-PAM parasites have been shown to differ antigenically and genetically. After multiple pregnancies, women from different geographical areas develop adhesion-blocking antibodies that protect against placental parasitemia and clinical symptoms of PAM. The recent description of a new parasite ligand encoded by the var2CSA gene as the only gene up-regulated in PAM parasites renders the development of an anti-PAM vaccine more feasible. The search for a vaccine to prevent P. falciparum sequestration in the placenta by eliciting adhesion-blocking antibodies and a cellular immune response, and the development of new methods for evaluating such antibodies should be key priorities in mother-child health programs in areas of endemic malaria. This review summarizes the main molecular, immunological and physiopathological aspects of PAM, including findings related to new targets in the P. falciparum var gene family. Finally, we focus on a new methodology for mimicking cytoadhesion under blood flow conditions in human placental tissue.

Lead reduces tension development and the myosin ATPase activity of the rat right ventricular myocardium

Lead (Pb2+) poisoning causes hypertension, but little is known regarding its acute effects on cardiac contractility. To evaluate these effects, force was measured in right ventricular strips that were contracting isometrically in 45 male Wistar rats (250-300 g) before and after the addition of increasing concentrations of lead acetate (3, 7, 10, 30, 70, 100, and 300 µM) to the bath. Changes in rate of stimulation (0.1-1.5 Hz), relative potentiation after pauses of 15, 30, and 60 s, effect of Ca2+ concentration (0.62, 1.25, and 2.5 mM), and the effect of isoproterenol (20 ng/mL) were determined before and after the addition of 100 µM Pb2+. Effects on contractile proteins were evaluated after caffeine treatment using tetanic stimulation (10 Hz) and measuring the activity of the myosin ATPase. Pb2+ produced concentration-dependent force reduction, significant at concentrations greater than 30 µM. The force developed in response to increasing rates of stimulation became smaller at 0.5 and 0.8 Hz. Relative potentiation increased after 100 µM Pb2+ treatment. Extracellular Ca2+ increment and isoproterenol administration increased force development but after 100 µM Pb2+ treatment the force was significantly reduced suggesting an effect of the metal on the sarcolemmal Ca2+ influx. Concentration of 100 µM Pb2+ also reduced the peak and plateau force of tetanic contractions and reduced the activity of the myosin ATPase. Results showed that acute Pb2+ administration, although not affecting the sarcoplasmic reticulum activity, produces a concentration-dependent negative inotropic effect and reduces myosin ATPase activity. Results suggest that acute lead administration reduced myocardial contractility by reducing sarcolemmal calcium influx and the myosin ATPase activity. These results also suggest that lead exposure is hazardous and has toxicological consequences affecting cardiac muscle.

Comparative efficacy and safety of the left versus right radial approach for percutaneous coronary procedures: a meta-analysis including 6870 patients

The radial approach is widely used in the treatment of patients with coronary artery disease. We conducted a meta-analysis of published results on the efficacy and safety of the left and right radial approaches in patients undergoing percutaneous coronary procedures. A systematic search of reference databases was conducted, and data from 14 randomized controlled trials involving 6870 participants were analyzed. The left radial approach was associated with significant reductions in fluoroscopy time [standardized mean difference (SMD)=-0.14, 95% confidence interval (CI)=-0.19 to -0.09; P<0.00001] and contrast volume (SMD=-0.07, 95%CI=-0.12 to -0.02; P=0.009). There were no significant differences in rate of procedural failure of the left and the right radial approaches [risk ratios (RR)=0.98; 95%CI=0.77-1.25; P=0.88] or procedural time (SMD=-0.05, 95%CI=0.17-0.06; P=0.38). Tortuosity of the subclavian artery (RR=0.27, 95%CI=0.14-0.50; P<0.0001) was reported more frequently with the right radial approach. A greater number of catheters were used with the left than with the right radial approach (SMD=0.25, 95%CI=0.04-0.46; P=0.02). We conclude that the left radial approach is as safe as the right radial approach, and that the left radial approach should be recommended for use in percutaneous coronary procedures, especially in percutaneous coronary angiograms.

Collective redundancies in the State of California of the United States and in the Republic of Finland. Procedures and Provisions

Video games industry has recently bonded California and Finland in a new way and where the employers are recruiting they also need to be aware of the provisions and procedures related to terminations. In general, collective dismissals are on a relatively high level both in Finland and in California. In California, collective redundancies are regulated under the WARN law. The WARN obligates employers with 75 or more employees to give a 60-day notice prior to a mass lay off and some other similar events. Employers with less than 75 employees are free to administer the terminations without the WARN notice period. Generally, the California at-will presumption allows employment relationship to be terminated any day with or without reason and without notice period if conditions of collective agreements or employment contract do not limit this right. Termination cannot anyhow be in violation of the anti-discrimination law. In Finland the termination related provisions are part of the Employment Contracts Act and the Act on Co-operation within Undertakings. Collective redundancies are allowed under financial and production related grounds. Small employers with less than 20 employees follow the termination provisions of the Employment Contracts Act and are obligated to inform the employee to be terminated on the details of the termination itself and also the services of the Employment and Economic Development Office. Employers with 20 or more employees are to initiate co-operation procedure under the Act on Co-operation within Undertakings when reducing personnel. The co- operation negotiations are to inform employees on the employer’s plans and financial situation as well as to involve them in the decision making regarding the terminations. The employer’s duty to inform the employees of the services of Employment and Economic Development Office needs to be fulfilled also in terminations under the co-operation procedure. Discrimination is prohibited in Finland in terminations of employment. As an alternative for terminations, employees can for example be transferred to another position or be temporarily laid off. Employer’s duties related to search of alternatives for layoff are broader in Finland than in California. The recent development of the labor laws in Finland and in California suggests that the labor law is not static in either one of these environments but changes can be expected as the needs of the business life so require.

“Who is steering the ship and which constellation guides the way? Exploring transparency in the European Central Bank during the time of crisis”

This paper explores transparency in the decision-making of the European Central Bank (ECB). According to ECB´s definition, transparency means that the central bank provides the general public with all relevant information on its strategy, assessments and policy decisions as well as its procedures in an open, clear and timely manner. In this paper, however, the interpretation of transparency is somewhat broader: Information is freely available and directly accessible to those who will be affected by the decisions. Moreover, the individuals shall be able to master this material. ECB´s negative attitude towards publication of documents has demonstrated central bank´s reluctance to strive towards more extensive transparency. By virtue of the definition adopted by the ECB the bank itself is responsible for determining what is considered as relevant information. On the grounds of EU treaties, this paper assesses ECB`s accountability concentrating especially on transparency by employing principal-agent theory and constitutional approach. Traditionally, the definite mandate and the tenet of central bank independence have been used to justify the limited accountability. The de facto competence of the ECB has, however, considerably expanded as the central bank has decisively resorted to non-standard measures in order to combat the economic turbulences facing Europe. It is alleged that non-standard monetary policy constitutes a grey zone occasionally resembling economic policy or fiscal policy. Notwithstanding, the European Court of Justice has repeatedly approved these measures. This dynamic interpretation of the treaties seems to allow temporarily exceptions from the central bank´s primary objective during extraordinary times. Regardless, the paper suggests that the accountability nexus defined in the treaties is not sufficient in order to guarantee the accountability of the ECB after the adoption of the new, more active role. Enhanced transparency would help the ECB to maintain its credibility. Investing in the quality of monetary dialogue between the Parliament and the ECB appears to constitute the most adequate and practicable method to accomplish this intention. As a result of upgraded transparency the legitimacy of the central bank would not solely rest on its policy outputs.

Collectiveness within startup teams – Leading the way to initiating and managing collective pursuit of opportunities in organizational contexts

While traditional entrepreneurship literature addresses the pursuit of entrepreneurial opportunities to a solo entrepreneur, scholars increasingly agree that new ventures are often founded and operated by entrepreneurial teams as collective efforts especially in hightechnology industries. Researchers also suggest that team ventures are more likely to survive and succeed than ventures founded by the individual entrepreneur although specific challenges might relate to multiple individuals being involved in joint entrepreneurial action. In addition to new ventures, entrepreneurial teams are seen central for organizing work in established organizations since the teams are able to create major product and service innovations that drive organizational success. Acknowledgement of the entrepreneurial teams in various organizational contexts has challenged the notion on the individual entrepreneur. However, considering that entrepreneurial teams represent a collective-level phenomenon that bases on interactions between organizational members, entrepreneurial teams may not have been studied as indepth as could be expected from the point of view of the team-level, rather than the individual or the individuals in the team. Many entrepreneurial team studies adopt the individualized view of entrepreneurship and examine the team members’ aggregate characteristics or the role of a lead entrepreneur. The previous understandings might not offer a comprehensive and indepth enough understanding of collectiveness within entrepreneurial teams and team venture performance that often relates to the team-level issues in particular. In addition, as the collective-level of entrepreneurial teams has been approached in various ways in the existing literatures, the phenomenon has been difficult to understand in research and practice. Hence, there is a need to understand entrepreneurial teams at the collective-level through a systematic and comprehensive perspective. This study takes part in the discussions on entrepreneurial teams. The overall objective of this study is to offer a description and understanding of collectiveness within entrepreneurial teams beyond individual(s). The research questions of the study are: 1) what collectiveness within entrepreneurial teams stands for, what constitutes the basic elements of it, and who are included in it, 2) why, how, and when collectiveness emerges or reinforces within entrepreneurial teams, and 3) why collectiveness within entrepreneurial teams matters and how it could be developed or supported. In order to answer the above questions, this study bases on three approaches, two set of empirical data, two analysis techniques, and conceptual study. The first data set consists of 12 qualitative semi-structured interviews with business school students who are seen as prospective entrepreneurs. The data is approached through a social constructionist perspective and analyzed through discourse analysis. The second data set bases on a qualitative multiplecase study approach that aims at theory elaboration. The main data consists of 14 individual and four group semi-structured thematic interviews with members of core entrepreneurial teams of four team startups in high-technology industries. The secondary data includes publicly available documents. This data set is approached through a critical realist perspective and analyzed through systematic thematic analysis. The study is completed through a conceptual study that aims at building a theoretical model of collective-level entrepreneurship drawing from existing literatures on organizational theory and social-psychology. The theoretical work applies a positivist perspective. This study consists of two parts. The first part includes an overview that introduces the research background, knowledge gaps and objectives, research strategy, and key concepts. It also outlines the existing knowledge of entrepreneurial team literature, presents and justifies the choices of paradigms and methods, summarizes the publications, and synthesizes the findings through answering the above mentioned research questions. The second part consists of five publications that address independent research questions but all enable to answer the research questions set for this study as a whole. The findings of this study suggest a map of relevant concepts and their relationships that help grasp collectiveness within entrepreneurial teams. The analyses conducted in the publications suggest that collectiveness within entrepreneurial teams stands for cognitive and affective structures in-between team members including elements of collective entity, collective idea of business, collective effort, collective attitudes and motivations, and collective feelings. Collectiveness within entrepreneurial teams also stands for specific joint entrepreneurial action components in which the structures are constructed. The action components reflect equality and democracy, and open and direct communication in particular. Collectiveness emerges because it is a powerful tool for overcoming individualized barriers to entrepreneurship and due to collectively oriented desire for, collective value orientation to, demand for, and encouragement to team entrepreneurship. Collectiveness emerges and reinforces in processes of joint creation and realization of entrepreneurial opportunities including joint analysis and planning of the opportunities and strategies, decision-making and realization of the opportunities, and evaluation, feedback, and sanctions of entrepreneurial action. Collectiveness matters because it is relevant for potential future entrepreneurs and because it affects the ways collective ventures are initiated and managed. Collectiveness also matters because it is a versatile, dynamic, and malleable phenomenon and the ideas of it can be applied across organizational contexts that require team work in discovering or creating and realizing new opportunities. This study further discusses how the findings add to the existing knowledge of entrepreneurial team literature and how the ideas can be applied in educational, managerial, and policy contexts.

Datenherrschaft – an Ethically Justified Solution to the Problem of Ownership of Patient Information

Patient information systems are crucial components for the modern healthcare and medicine. It is obvious that without them the healthcare cannot function properly – one can try to imagine how brain surgery could be done without using information systems to gather and show information needed for an operation. Thus, it can be stated that digital information is irremovable part of modern healthcare. However, the legal ownership of patient information lacks a coherent and justified basis. The whole issue itself is actually bypassed by controlling pa- tient information with different laws and regulations how patient information can be used and by whom. Nonetheless, the issue itself – who owns the patient in- formation – is commonly missed or bypassed. This dissertation show the problems if the legislation of patient information ownership is not clear. Without clear legislation, the outcome can be unexpected like it seems to be in Finland, Sweden and United Kingdom: the lack of clear regulation has come up with unwanted consequences because of problematic Eu- ropean Union database directive implementation in those countries. The legal ownership is actually granted to the creators of databases which contains the pa- tient information, and this is not a desirable situation. In healthcare and medicine, we are dealing with issues such as life, health and information which are very sensitive and in many cases very personal. Thus, this dissertation leans on four philosophical theories form Locke, Kant, Heidegger and Rawls to have an ethically justified basis for regulating the patient infor- mation in a proper way. Because of the problems of property and ownership in the context of information, a new concept is needed and presented to replace the concept of owning, that concept being Datenherrschaft (eng. mastery over in- formation). Datenherrschaft seems to be suitable for regulating patient infor- mation because its core is the protection of one’s right over information and this aligns with the work of the philosophers whose theories are used in the work. The philosophical argumentation of this study shows that Datenherrschaft granted to the patients is ethically acceptable. It supports the view that patient should be controlling the patient information about themselves unless there are such specific circumstance that justifies the authorities to use patient information to protect other people’s basic rights. Thus, if the patients would be legally grant- ed Datenherrschaft over patient information we would endorse patients as indi- viduals who have their own and personal experience of their own life and have a strong stance against any unjustified paternalism in healthcare. Keywords: patient information, ownership, Datenherrschaft, ethics, Locke, Kant, Heidegger, Rawls

Has social justice any legitimacy in Kant's theory of right? The empirical conditions of the legal state as a civil union

This paper aims at shedding light on an obscure point in Kant's theory of the state. It discusses whether Kant's rational theory of the state recognises the fact that certain exceptional social situations, such as the extreme poverty of some parts of the population, could request institutional state support in order to guarantee the attainment of a minimum threshold of civil independence. It has three aims: 1) to show that Kant's Doctrine of Right can offer solutions for the complex relation between economics and politics in our present time; 2) to demonstrate the claim that Kant embraces a pragmatic standpoint when he tackles the social concerns of the state, and so to refute the idea that he argues for an abstract conception of politics; and 3) to suggest that a non-paternalistic theory of rights is not necessarily incompatible with the basic tenets of a welfare state.

Heidegger on the way of thinking

This thesis attempts to clarify what Heidegger meant by the term "thinking" (Denken), where this ^'meanr is submitted in the double sense: firstly, in the sense of what Heidegger intended by the use and exposition of this term that we find in his lecture series. Was Heisst Denken?, where Heidegger quickly makes it clear that this intention is to actually bring thinking on the way, viz. making provision for the leap into thinking, and where this intention was carried out with the employment of a specific guiding phrase. In the second sense, it is an attempt at clarifying the meaning of the term. But this is not to say that we are here simply out to see how Heidegger defines the word '*thinking." It is in fact precisely within such definitive discourse that thought dies out. It is not merely be a case of defining a word, because this enterprise would be just as shallow as much as it would be unworkable. It is for this reason that Heidegger decided to establish for himself the task, not merely of explaining thinking as something to be beheld at a distance, but rather of bringing thinking underway by means of his lecture, proclaiming that, "Only the leap into the river tells us what is swimming. The question 'What is called thinking?' can never be answered by proposing a definition of the concept thinking, and then diligently explaining what is contained in that definition." (WCT, 21) This being Heidegger's intention, in order to understand Heidegger in his treatment of the term thinking, it is clear that we must also undergo an experience with thinking. It is in this spirit that the present work was written so as to collaborate the two senses of what Heidegger meant by "thinking."

Effect of combined care nursing on patient satisfaction, staff satisfaction, and quality of care /

This research evaluates the effect of combined care nursing on three outcomes: i) patient satisfaction; ii) staff satisfaction; and iii) quality of care. Oakville-Trafalgar Memorial Hospital was in the early planning stages of changing to combined care nursing from the traditional method of providing separate postpartum and nursery care to mothers and babies. The opportunity existed to evaluate formally the change to combined care. There were three hypotheses to be investigated. Data were collected from four sources: patient surveys, staff surveys, informal interviews, and internal hospital documents. Both quantitative and qualitative data were analyzed. The surveys were administered on three different occasions to patients and staff. Other sources of data included informal interviews with patients and staff who responded to the surveys, and chart audits.The study findings revealed that the majority of respondents had increased levels of satisfaction and perceptions of increased quality of care following implementation of combined care. These findings, related to combined care and the role of change in its implementation and evaluation, indicate that there are no right or easy answers about how to make new ideas become reality in a smooth, pleasant way.