Lean Methods and Digital Technologies in Healtchare

The experiences of several healthcare organizations were considered to distinguish the most frequently used lean tools, the success and failure factors, and the obstacles that may appear while implementing lean. As a result, two approaches to “go lean” were defined, and analyzed from the prospective of the applicability to healthcare processes. Industrialization of healthcare was studied, and the most promising digital technology tools to improve healthcare process were highlighted. Finally, the analysis of healthcare challenges and feasible ways to address them was conducted and presented as the main result of this work. The possible ways of implementation of the findings and limitations were described in the conclusion.

A Brazilian family with hereditary inclusion body myopathy associated with Paget disease of bone and frontotemporal dementia

Inclusion body myopathy associated with Paget disease and frontotemporal dementia (IBMPFD) is a progressive and usually misdiagnosed autosomal dominant disorder. It is clinically characterized by a triad of features: proximal and distal myopathy, early onset Paget disease of bone (PDB), and frontotemporal dementia (FTD). It is caused by missense mutations in the valosin-containing protein (VCP) gene. We describe here the clinical and molecular findings of the first Brazilian family identified with IBMPFD. Progressive myopathy affecting the limb girdles was detected by clinical examination followed by muscle biopsy and creatine kinase measurement. PDB was suggested after anatomopathological bone examination and FTD was diagnosed by clinical, neuropsychological and language evaluations. Brain magnetic resonance revealed severe atrophy of the anterior temporal lobes, including the hippocampi. A R93C mutation in VCP was detected by direct sequencing screening in subject W (age 62) and in his mother. Four more individuals diagnosed with "dementia" were reported in this family. We also present a comprehensive genotype-phenotype correlation analysis of mutations in VCP in 182 patients from 29 families described in the literature and show that while IBM is a conspicuously penetrant symptom, PDB has a lower penetrance when associated with mutations in the AAAD1 domain and FTD has a lower penetrance when associated with mutations in the Junction (L1-D1) domain. Furthermore, the R93C mutation is likely to be associated with the penetrance of all the clinical symptoms of the triad.

Visuell läsning som kompetensområde : en pedagogisk studie i visuell grammatik inom multimodal digital kommunikation

Avhandlingens primära syfte är att upprätta en förståelse för visuell kompetens som en del av visuell litteracitet inom multimodal digital kommunikation i undervisningen. Avhandlingens sekundära syfte är att ur ett pedagogiskt perspektiv lyfta fram visuell litteracitet och visuell kompetens i multimodala diskussioner kring digital pedagogik. Forskningen är kvalitativ och har både teoretisk och empirisk förankring. Den empiriska studien har en fenomenologisk metodansats. Visuell kompetens innebär att visuell läsning behärskas, vilket förutsätter fungerande vokabulär, kritiskt förhållningssätt och kunskaper i läsning och tolkning och användning av bilder. Den visuella grammatikteorin innefattar bildens syntax och semantik. Bilden är ett kontextbundet fenomen, där kontexten berör sociala aspekter, bildens fysiska omgivning samt innehåll. Det empiriska resultatet är att visuell inverkan i undervisningen präglar förberedelser och lektionsmål, berör visuell kommunikationskompetens, inkluderar visuella element som verktyg, strävar involvera flera element i inlärningen och strävar efter att undvika passiva demonstrationer som undervisningsmetod. Bilder behövs som kommunikativt stöd, som inlärningsmetod och som en del i aktivitetspedagogisk undervisning. Genom stöd från läraren kan barnet nå visuell litteracitet som ett kompetensmål, vilket kan ske genom multimodal undervisning.

Thoughts on work-in-progress crowdsourcing metrics of digital collections

The presentation consists of work-in-progress metrics of #digitalkoot, the crowdsourcing project launched by National Library of Finland

Digital content and making it viral in social media

Tutkimuksen tavoite on selvittää digitaalisen sisällön ominaisuuksia, jotka vaikuttavat ryhtyvätkö kuluttajat jakamaan, tykkäämään ja kommentoimaan sitä sosiaalisessa mediassa. Tällä pyritään auttamaan yrityksiä ymmärtämään paremmin viraalisuutta, jotta he pystyisivät tuottamaan ja julkaisemaan nettisivuillaan ja sosiaalisessa mediassa parempaa sisältöä, jota kuluttajat jakaisivat enemmän. Tutkimus toteutetaan muodostamalla hypoteeseja mahdollisista ominaisuuksista kirjallisuuden perusteella ja testaamalla niitä regressioanalyyseillä empiirisessä osiossa. Tulokset paljastavat yhdeksän piirrettä, jotka lisäävät viraalisuutta: kiinnostavuus, neutraalisuus, yllättävyys, viihdyttävyys, epäkäytännöllisyys, artikkelin ja Facebook julkaisun pituus, eri sisältö taktiikoiden käyttö (erityisesti blogit ja kuvat lisäävät viraalisuutta) sekä kun mielipidevaikuttaja tai kuuluisuus jakaa sisällön.

Inclusion or Exclusion? Trade union strategies and Labor migration

Inclusion or Exclusion? Trade Union Strategies and Labor Migration This research identified and analyzed immigration-related strategies of the Finnish Construction Trade Union (FCTU) and the Service Union United (SUU); e.g. how the unions react to labor immigration, whether unions seek to include migrants in the unions, and what is migrants’ position in the unions. The two unions were chosen as the focus of the research because the workforce in the sectors they represent is migrant-dense. The study also analyzed the experiences that migrants who work in these sectors have with trade unions. The Estonian labor market situation –including the role of Estonian trade unions– was also examined as it has a considerable impact on the operating environment of the FCTU. The results of the study indicate that immigration is a contradictory issue for both unions. On the one hand, they strive to include migrants as trade union members and to defend migrants’ labor rights. On the other hand, they, together with their umbrella organization the Central Organisation of Finnish Trade Unions (SAK), seek to prevent labor immigration from outside the EU and EEA countries. They actively defend current labor immigration restrictions by drawing atten- tion to high unemployment figures and to the breaches of working conditions migrants encounter. In contrast, the employer organizations promote a more liberal state policy on labor immigration because they see it as a boost for business. Both the unions and the employer organizations ground their arguments on national interest. However, the position of the trade union movement is not uniform: unions belonging to the Confederation of Unions for Professionals and Managerial Staff in Finland (Akava) embrace more liberal labor immigration stances than the SAK. A key trade union strategy is to try to guarantee that migrants’ working condi- tions do not differ from those of the natives. The FCTU and the SUU inform migrants about Finnish collective agreements and trade union membership in the most common migrant languages. This is important for the unions because it is not in their interest that migrants’ working conditions are undercut. The interviewed migrants said that natives had more negotiating power with employers, which is often negatively portrayed in migrants’ working conditions. Migrants perceive that trade unions have an important role in protecting their working conditions. However, they stressed that migrants’ knowledge of unions is often very limited. The number of migrants in both two unions studied here is increasing. Espe- cially in the SUU, a considerable proportion of the new members are migrants. The FCTU is in a more challenging situation than the SUU because migrant construc- tion workers often work only for short periods in Finland and are consequently not interested in becoming union members. The unions’ strategies partly differ: the FCTU was the first Finnish trade union to establish a trade union branch/lo- cal for migrant members. The goal is to facilitate migrants’ inclusion in the union and to highlight the specific problems they face. The SUU, for its part, insists that such a special strategy would exclude migrants within the union organization. Despite the unions’ strategies, migrants are still underrepresented as union members and officials, which some of the interviewed migrants saw as a problem. Immigrants’ perception of trade unions was pragmatic: they had joined unions when membership yielded concrete benefits. In spite of the unions’ strategies, migrants –and temporary migrants– encoun- ter specific problems in terms of working conditions. Both unions demand more state intervention to protect migrants’ labor rights because overseeing working conditions consumes union resources. However, without the unions’ intervention, these problems would be more common than is currently the case. For instance, some of the interviewed migrants had received trade union assistance in claim- ing unpaid wages. The study demonstrated with the help of building on Walter Korpi’s power resources theory, that immigration is a power resource issue for the unions: suc- cessful immigration-related strategies strengthen unions –and vice versa. The research also showed how the unions’ operating environments constrain and enable their immigration-related strategies. This study has illuminated a previously ignored dimension: the immigrant- inclusive strategies of the Finnish trade unions. The research material consists of 78 qualitative interviews, observation in trade union events, and trade unions’ and employer organizations’ public state- ments.

Evaluating digital marketing content management strategies in an international company.

The purpose of this thesis is to explore a different kind of digital content management model and to propose a process in order to manage properly the content on an organization’s website. This process also defines briefly the roles and responsibilities of the different actors implicated. In order to create this process, the thesis has been divided into two parts. First, the theoretical analysis helps to find the two main different content management models, content management adaptation and content management localization model. Each of these models, have been analyzed through a SWOT model in order to identify their particularities and which of them is the best option according to particular organizational objectives. In the empirical part, this thesis has measured the organizational website performance comparing two main data. On one hand, the international website is analyzed in order to identify the results of the content management standardization. On the other hand, content management adaptation, also called content management localization model, is analyzed by looking through the key measure of the Dutch page from the same organization. The resulted output is a process model for localization as well as recommendations on how to proceed when creating a digital content management strategy. However, more research is recommended to provide more comprehensive managerial solutions.

Digital Exhaustion in relation to Video Games – The Consumer Perspective

This thesis regards exhaustion of copyright’s distribution right in intangible transfers of video games. It analyses whether, under the current law of the European Union, the phenomenon of digital exhaustion, especially in relation to games exists. The thesis analyses the consumers’ position in the market for copyright protected goods. It uses video games market as an example of the wider phenomenon of the effect of latest technological developments on consumers. The research conducted for the thesis is mostly legal dogmatic, although also comparative analysis, law and economics and law and technology methods are utilised. The thesis evaluates the effects of the most recent case law of the European Court of Justice to analyse the current state of digital exhaustion. In the analysis of effects that the existence of digital exhaustion has, the thesis uses the consumers’ point of view. The thesis introduces the current state of technology in the field of video games from a legal perspective. Furthermore the thesis analyses the effects on consumers of a scenario that no digital exhaustion exists in the future. Such scenario under the recent European case law at the moment seems realistic. The conclusion of my research is most importantly that the consumer position in the market for digital goods has deteriorated and that the probable exclusion of the exhaustion for digital goods is another piece of evidence of this development. Most importantly however, the state of affairs where no certainty prevails on whether digital exhaustion exists, creates injustice from the consumers’ point of view. Accordingly, acts by EU legislators of the Court of Justice of the European Union are required to clarify the issue.

Similaridade entre os valores da pressão arterial aferida pelo método auscultatório com aparelho de coluna de mercúrio e o método oscilométrico automático com aparelho digital

INTRODUÇÃO: Um dos maiores desafios no manejo da hipertensão arterial é o adequado controle pressórico. Para se alcançar esse objetivo tem se difundido a medida residencial da pressão arterial (MRPA) com aparelhos automáticos. Entretanto, parte da comunidade médico-científica ainda discute sua validade, acreditando que as medidas pressóricas domiciliares podem ser incorretas. OBJETIVO: Avaliar a correspondência entre as medidas simultâneas da pressão arterial (PA) pelo método auscultatório convencional e método digital automático, habitualmente utilizado na MRPA. MÉTODOS: Através de uma conexão em "Y" acoplamos um manguito a um aparelho digital automático validado (ONROM 705IT) e a um esfigmomanômetro de coluna de mercúrio, permitindo aferir simultaneamente a PA pelos dois métodos. Determinamos a PA em 423 indivíduos (normotensos e hipertensos), adequando o tamanho do manguito à circunferência braquial. RESULTADOS: Os valores representam média ± desvio padrão (DP) (valores mínimo-máximo): Idade 40,8 ± 16,3 anos (18-92), circunferência braquial 28,2 ± 3,7 cm (19-42), PA sistólica (PAS) auscultatório 127,6 ± 22,8 mmHg (69-223), PAS automático 129,5 ± 23,0 mmHg (56-226), PA diastólica (PAD) auscultatório 79,5 ± 12,6 mmHg (49-135), PAD automático 79,0 ± 12,6 mmHg (48-123). A diferença média da PAS entre os dois métodos foi de 1,9 mmHg (-15 a +19) e a diferença da PAD de 0,5 mmHg (-19 a +13). Os índices de correlação de Pearson entre os métodos são para a PAS (r = 0,97), e PAD (r = 0,91). A análise de Bland-Altman mostrou concordância clinicamente aceitável entre os métodos. CONCLUSÃO: A PA aferida pelo método digital automático apresenta boa concordância com o método auscultatório convencional, devendo ser usada no auxílio do diagnóstico e controle da hipertensão arterial (HA).

Formal modelling for digital media distribution

Human beings have always strived to preserve their memories and spread their ideas. In the beginning this was always done through human interpretations, such as telling stories and creating sculptures. Later, technological progress made it possible to create a recording of a phenomenon; first as an analogue recording onto a physical object, and later digitally, as a sequence of bits to be interpreted by a computer. By the end of the 20th century technological advances had made it feasible to distribute media content over a computer network instead of on physical objects, thus enabling the concept of digital media distribution. Many digital media distribution systems already exist, and their continued, and in many cases increasing, usage is an indicator for the high interest in their future enhancements and enriching. By looking at these digital media distribution systems, we have identified three main areas of possible improvement: network structure and coordination, transport of content over the network, and the encoding used for the content. In this thesis, our aim is to show that improvements in performance, efficiency and availability can be done in conjunction with improvements in software quality and reliability through the use of formal methods: mathematical approaches to reasoning about software so that we can prove its correctness, together with the desirable properties. We envision a complete media distribution system based on a distributed architecture, such as peer-to-peer networking, in which different parts of the system have been formally modelled and verified. Starting with the network itself, we show how it can be formally constructed and modularised in the Event-B formalism, such that we can separate the modelling of one node from the modelling of the network itself. We also show how the piece selection algorithm in the BitTorrent peer-to-peer transfer protocol can be adapted for on-demand media streaming, and how this can be modelled in Event-B. Furthermore, we show how modelling one peer in Event-B can give results similar to simulating an entire network of peers. Going further, we introduce a formal specification language for content transfer algorithms, and show that having such a language can make these algorithms easier to understand. We also show how generating Event-B code from this language can result in less complexity compared to creating the models from written specifications. We also consider the decoding part of a media distribution system by showing how video decoding can be done in parallel. This is based on formally defined dependencies between frames and blocks in a video sequence; we have shown that also this step can be performed in a way that is mathematically proven correct. Our modelling and proving in this thesis is, in its majority, tool-based. This provides a demonstration of the advance of formal methods as well as their increased reliability, and thus, advocates for their more wide-spread usage in the future.

Influencing Perceived Agency: A Study into User Experiences in Digital Interactive Storytelling

User experience is a crucial element in interactive storytelling, and as such it is important to recognize the different aspects of a positive user experience in an interactive story. Towards that goal, in the first half of this thesis, we will go through the different elements that make up the user experience, with a strong focus on agency. Agency can be understood as the user’s ability to affect the story or the world in which the story is told with interesting and satisfying choices. The freedoms granted by agency are not completely compatible with traditional storytelling, and as such we will also go through some of the issues of agency-centric design philosophies and explore alternate schools of thought. The core purpose of this thesis is to determine the most important aspects of agency with regards to a positive user experience and attempt to find ways for authors to improve the overall quality of user experience in interactive stories. The latter half of this thesis deals with the research conducted on this matter. This research was carried out by analyzing data from an online survey coupled with data gathered by the interactive storytelling system specifically made for this research (Regicide). The most important aspects of this research deal with influencing perceived agency and facilitating an illusion of agency in different ways, and comparing user experiences in these different test environments. The most important findings based on this research include the importance of context-controlled and focused agency and settings in which the agency takes place and the importance of ensuring user-competency within an interactive storytelling system. Another essential conclusion to this research boils down to communication between the user and the system; the goal of influencing perceived agency should primarily be to ensure that the user is aware of all the theoretical agency they possess.

Practices of Inclusion and Exclusion in Premodern Culture

In Practices of Inclusion and Exclusion in Premodern Culture a group of Finnish cultural historians discuss the meanings of cultural belonging, experiences and practices of construing boundaries between cultures and their others. What were the motives behind these constructions of differences in Premodern cultures? Why and through what kind of practices were differences created in specific cultural contexts? This book deals with Premodern people having multiple ways of construing their relationship to others, simultaneously being active agents in their own lives. Practices of Inclusion and Exclusion in Premodern Culture is suitable for course book for Master's Degree studies of history.