Written Cancer Narratives : An Ethnomedical Study of Cancer Patients' Thoughts, Emotions and Experiences

Since the second half of the 20th century, cancer has become a dominant disease in Western countries, endangering people regardless of age, gender, race or social status. Every year almost eight million people die of cancer worldwide. In Finland every fourth person is expected to fall ill with cancer at some stage of his or her life. During the 20th century, along with rapid changes in the medical system, people s awareness of cancer has increased a great deal. This has also influenced the image of cancer in popular discourse over the past decades. However, from the scientific point of view there is still much that is unclear about the disease. This thesis shows that this is a big problem for ordinary people, as, according to culture-bound illness ideology, people need an explanation about the origin of their illness in order to help them cope. The main aim of this thesis is to examine the process of being ill with cancer from the patient s point of view, in order to analyse attitudes and behaviour towards cancer and its significance and culture-bound images. This narrative-based study concentrates on patients voicings , which are important in understanding the cancer experience and when attempting to make it more open within current cultural and societal settings. The Kun sairastuin syöpään ( when I fell ill with cancer ) writing competition organised by Suomen Syöpäpotilaat ry (the Finnish Cancer Patients Association), Suomen Syöpäyhdistys ry (the Finnish Cancer Union), and Suomalaisen Kirjallisuuden Seuran kansanrunousarkisto (the Finnish Literary Society Folklore Archive) was announced on the 1st of May 1994 and lasted until the 30th of September 1994. As a result, a total of 672 cancer narratives, totalling 6384 pages, were received, filled with experiences relating to cancer. Written cancer narratives form a body of empirical data that is suitable for content or textual analysis. In this thesis, content analysis is adopted in order to become familiar with the texts and to preselect the themes and analytical units for further examination. I use multiple perspectives in order to interpret cancer patients ideas and reasoning. The ethnomedical approach unites popular health beliefs that originated in Finnish folk medicine, as well as connecting alternative medicine, which patients make use of, with biomedicine, the dominant form of medicine today. In addition to this, patients narratives, which are composed of various structural segments, are approached from the folklorist s perspective. In this way they can be seen as short pathographies, reconstructions of self-negotiation and individual decision making during the illness process. Above all, cancer patients writing describe their feelings, thoughts and experiences. Factors that appear insignificant to modern medicine, overwhelmed as it is by medical technologies that concentrate on dysfunctional tissue within diseased bodies. Ethnomedical study of cancer patients writings gives access to the human side of cancer discourse, and combines both medical, and popular, knowledge of cancer. In my view, the natural world and glimpses of tradition are bound together with one general aim within cancer narratives: to tackle the illness and mediate its meanings. Furthermore, the narrative approach reveals that participants write with the hope of offering a different interpretation of the cancer experience, and thus of confronting culturally pre-defined images and ideologies.

Free-to-bound and bound exciton transitions at isoelectronic impurities: GaP(Zn,O)

We show, for sufficiently high temperatures and sufficiently weak majority-carrier binding energies, that the dominant radiative transition at an isoelectronic acceptor (donor) in p-type (n-type) material consists of the recombination of singly trapped minority carriers (bound by central-cell forces) with free majority carriers attracted by a Coulomb interaction. There are two reasons why the radiative recombination rate of the free-to-bound process is greater than the bound exciton process, which dominates at lower temperatures: (i) The population of free majority-carrier states greatly exceeds that of exciton states at higher temperatures, and (ii) the oscillator strength of the free-to-bound transition is greatly enhanced by the Coulomb attraction between the free carrier and the charged isoelectronic impurity. This enhancement is important for isoelectronic centers and is easily calculable from existing exciton models. We show that the free carrier attracted by a Coulomb interaction can be viewed as a continuum excited state of the bound exciton. When we apply the results of our calculations to the GaP(Zn, O) system, we find that the major part of the room-temperature luminescence from nearest-neighbor isoelectronic Zn-O complexes results from free-to-bound recombination and not exciton recombination as has been thought previously. Recent experiments on impulse excitation of luminescence in GaP(Zn, O) are reevaluated in the light of our calculations and are shown to be consistent with a strong free-to-bound transition. For deep isoelectronic centers with weakly bound majority carriers, we predict an overwhelming dominance of the free-to-bound process at 300°K.

Dielectric relaxation and electrical conductivity in Bi5NbO10 oxygen ion conductors prepared by a modified sol–gel process

Crystalline Bi5NbO10 nanoparticles have been achieved through a modified sol–gel process using a mixture of ethylenediamine and ethanolamine as a solvent. The Bi5NbO10 nanoparticles were characterized by X-ray diffraction (XRD), differential scanning calorimetry/thermogravimetry (DSC/TG), Fourier transform infrared spectroscopy (FT-IR), transmission electron microscopy (TEM) and Raman spectroscopy. The results showed that well-dispersed 5–60 nm Bi5NbO10 nanoparticles were prepared through heat-treating the precursor at 650 °C and the high density pellets were obtained at temperatures lower than those commonly employed. The frequency and temperature dependence of the dielectric constant and the electrical conductivity of the Bi5NbO10 solid solutions were investigated in the 0.1 Hz to 1 MHz frequency range. Two distinct relaxation mechanisms were observed in the plots of dielectric loss and the imaginary part of impedance (Z″) versus frequency in the temperature range of 200–350 °C. The dielectric constant and the loss in the low frequency regime were electrode dependent. The ionic conductivity of Bi5NbO10 solid solutions at 700 °C is 2.86 Ω−1 m−1 which is in same order of magnitude for Y2O3-stabilized ZrO2 ceramics at same temperature. These results suggest that Bi5NbO10 is a promising material for an oxygen ion conductor.

A model Integrating the Facilities Management Process with the Building End User’s Business Process (ProFacil)

The ProFacil model is a generic process model defined as a framework model showing the links between the facilities management process and the building end user’s business process. The purpose of using the model is to support more detailed process modelling. The model has been developed using the IDEF0 modelling method. The ProFacil model describes business activities from the generalized point of view as management-, support-, and core processes and their relations. The model defines basic activities in the provision of a facility. Examples of these activities are “operate facilities”, “provide new facilities”, “provide re-build facilities”, “provide maintained facilities” and “perform dispose of facilities”. These are all generic activities providing a basis for a further specialisation of company specific FM activities and their tasks. A facilitator can establish a specialized process model using the ProFacil model and interacting with company experts to describe their company’s specific processes. These modelling seminars or interviews will be done in an informal way, supported by the high-level process model as a common reference.

A Formalised Model of the Information and Materials Handling Activities in the Construction Process

A model of the information and material activities that comprise the overall construction process is presented, using the SADT activity modelling methodology. The basic model is further refined into a number of generic information handling activities such as creation of new information, information search and retrieval, information distribution and person-to-person communication. The viewpoint could be described as information logistics. This model is then combined with a more traditional building process model, consisting of phases such as design and construction. The resulting two-dimensional matrix can be used for positioning different types of generic IT-tools or construction specific applications. The model can thus provide a starting point for a discussion of the application of information and communication technology in construction and for measurements of the impacts of IT on the overall process and its related costs.

Developing a Multidisciplinary Process View of IFC Standardization

The industry foundation classes (IFC) file format is one of the most complex and ambitious IT standardization projects currently being undertaken in any industry, focusing on the development of an open and neutral standard for exchanging building model data. Scientific literature related to the IFC standard has dominantly been technical so far; research looking at the IFC standard from an industry standardization per- spective could offer valuable new knowledge for both theory and practice. This paper proposes the use of IT standardization and IT adoption theories, supported by studies done within construction IT, to lay a theoretical foundation for further empirical analysis of the standardization process of the IFC file format.

CAD Standardization in Construction – a Process View

There has been a demand for uniform CAD standards in the construction industry ever since the large-scale introduction of computer aided design systems in the late 1980s. While some standards have been widely adopted without much formal effort, other standards have failed to gain support even though considerable resources have been allocated for the purpose. Establishing a standard concerning building information modeling has been one particularly active area of industry development and scientific interest within recent years. In this paper, four different standards are discussed as cases: the IGES and DXF/DWG standards for representing the graphics in 2D drawings, the ISO 13567 standard for the structuring of building information on layers, and the IFC standard for building product models. Based on a literature study combined with two qualitative interview studies with domain experts, a process model is proposed to describe and interpret the contrasting histories of past CAD standardisation processes.

The international match: Metaphors as vehicles of social identity building in cross-border mergers

This article focuses on cultural identity-building in the cross-border merger context. To provide an alternative to the dominant essentialist analyses of cultures and cultural differences, cultural identitybuilding is conceptualized as a metaphoric process. The focus is on two processes inherent in the cross-border merger context: construction of images of Us and Them and construction of images of a Common Future. Based on an analysis of a special metaphor exercise carried out in a recent Finnish–Swedish merger, the article illustrates how the metaphoric perspective reveals specific cognitive, emotional and political aspects of cultural identity-building that easily remain ‘hidden’ in the case of more traditional approaches.

Service Experience in an Innovation Context

Service researchers and practitioners have repeatedly claimed that customer service experiences are essential to all businesses. Therefore comprehension of how service experience is characterised in research is an essential element for its further development through research. The importance of greater in-depth understanding of the phenomenon of service experience has been acknowledged by several researchers, such as Carú and Cova and Vargo and Lusch. Furthermore, Service-Dominant (S-D) logic has integrated service experience to value by emphasising in its foundational premises that value is phenomenologically (experientially) determined. The present study analyses how the concept of service experience has been characterised in previous research. As such, it puts forward three ways to characterise it in relation to that research: 1) phenomenological service experience relates to the value discussion in S-D logic and interpretative consumer research, 2) process-based service experience relates to understanding service as a process, and 3) outcome-based service experience relates to understanding service experience as one element in models linking a number of variables or attributes to various outcomes. Focusing on the phenomenological service experience, the theoretical purpose of the study is to characterise service experience based on the phenomenological approach. In order to do so, an additional methodological purpose was formulated: to find a suitable methodology for analysing service experience based on the phenomenological approach. The study relates phenomenology to a philosophical Husserlian and social constructionist tradition studying phenomena as they appear in our experience in a social context. The study introduces Event-Based Narrative Inquiry Technique (EBNIT), which combines critical events with narratives and metaphors. EBNIT enabled the analysis of lived and imaginary service experiences as expressed in individual narratives. The study presents findings of eight case studies within service innovation of Web 2.0, mobile service, location aware service and public service in the municipal sector. Customers’ and service managers’ stories about their lived private and working lifeworld were the foundation for their ideal service experiences. In general, the thesis finds that service experiences are (1) subjective, (2) context-specific, (3) cumulative, (4) partially socially constructed, (5) both lived and imaginary, (6) temporally multiple-dimensional, and (7) iteratively related to perceived value. In addition to customer service experience, the thesis brings empirical evidence of managerial service experience of front-line managers experiencing the service they manage and develop in their working lifeworld. The study contributes to S-D logic, service innovation and service marketing and management in general by characterising service experience based on the phenomenological approach and integrating it to the value discussion. Additionally, the study offers a methodological approach for further exploration of service experiences. The study discusses managerial implications in conjunction with the case studies and discusses them in relation to service innovation.

New Evidence on the Properties of the Financial Statement Information Pricing Process

This study contributes to our knowledge of how information contained in financial statements is interpreted and priced by the stock market in two aspects. First, the empirical findings indicate that investors interpret some of the information contained in new financial statements in the context of the information of prior financial statements. Second, two central hypotheses offered in earlier literature to explain the significant connection between publicly available financial statement information and future abnormal returns, that the signals proxy for risk and that the information is priced with a delay, are evaluated utilizing a new methodology. It is found that the mentioned significant connection for some financial statement signals can be explained by that the signals proxy for risk and for other financial statement signals by that the information contained in the signals is priced with a delay.

Studies on design, fabrication and reliability assessment of embedded passives on a high-density interconnect (HDI) organic substrate using a sequential build-up process

One of the foremost design considerations in microelectronics miniaturization is the use of embedded passives which provide practical solution. In a typical circuit, over 80 percent of the electronic components are passives such as resistors, inductors, and capacitors that could take up to almost 50 percent of the entire printed circuit board area. By integrating passive components within the substrate instead of being on the surface, embedded passives reduce the system real estate, eliminate the need for discrete and assembly, enhance electrical performance and reliability, and potentially reduce the overall cost. Moreover, it is lead free. Even with these advantages, embedded passive technology is at a relatively immature stage and more characterization and optimization are needed for practical applications leading to its commercialization.This paper presents an entire process from design and fabrication to electrical characterization and reliability test of embedded passives on multilayered microvia organic substrate. Two test vehicles focusing on resistors and capacitors have been designed and fabricated. Embedded capacitors in this study are made with polymer/ceramic nanocomposite (BaTiO3) material to take advantage of low processing temperature of polymers and relatively high dielectric constant of ceramics and the values of these capacitors range from 50 pF to 1.5 nF with capacitance per area of approximately 1.5 nF/cm(2). Limited high frequency measurement of these capacitors was performed. Furthermore, reliability assessments of thermal shock and temperature humidity tests based on JEDEC standards were carried out. Resistors used in this work have been of three types: 1) carbon ink based polymer thick film (PTF), 2) resistor foils with known sheet resistivities which are laminated to printed wiring board (PWB) during a sequential build-up (SBU) process and 3) thin-film resistor plating by electroless method. Realization of embedded resistors on conventional board-level high-loss epoxy (similar to 0.015 at 1 GHz) and proposed low-loss BCB dielectric (similar to 0.0008 at > 40 GHz) has been explored in this study. Ni-P and Ni-W-P alloys were plated using conventional electroless plating, and NiCr and NiCrAlSi foils were used for the foil transfer process. For the first time, Benzocyclobutene (BCB) has been proposed as a board level dielectric for advanced System-on-Package (SOP) module primarily due to its attractive low-loss (for RF application) and thin film (for high density wiring) properties.Although embedded passives are more reliable by eliminating solder joint interconnects, they also introduce other concerns such as cracks, delamination and component instability. More layers may be needed to accommodate the embedded passives, and various materials within the substrate may cause significant thermo -mechanical stress due to coefficient of thermal expansion (CTE) mismatch. In this work, numerical models of embedded capacitors have been developed to qualitatively examine the effects of process conditions and electrical performance due to thermo-mechanical deformations.Also, a prototype working product with the board level design including features of embedded resistors and capacitors are underway. Preliminary results of these are presented.

Rethinking Service Companies’ Business Logic: Do We Need a Customer-Dominant Logic as a Guideline?

Purpose –This paper explores and expands the roles of customers and companies in creating value by introducing a new a customer-based approach to service. The customer’s logic is examined as being the foundation of a customer-based marketing and business logic. Design/methodology/approach – The authors argue that both goods-dominant logics and service-dominant logics are provider-dominant. Contrasting the customer-dominant logic with provider-dominant logics, the paper examines the creation of service value from the perspectives of value-in-use, the customer’s own context, and the customer’s experience of service. Findings –Moving from a provider-dominant logic to a customer-dominant logic uncovered five major challenges to service marketers: Company involvement, company control in co-creation, visibility of value creation, locus of customer experience, and character of customer experience. Research limitations/implications – The paper is exploratory. It presents and discusses a conceptual model and suggests implications for research and practice. Practical implications –Awareness of the mechanisms of customer logic will provide businesses with new perspectives on the role of the company in their customer’s lives. We propose that understanding the customer’s logic should represent the starting-point for the marketer’s business logic. Originality/value – The paper increases the understanding of how the customer’s logic underpins the customer-dominant business logic. By exploring consequences of applying a customer-dominant logic, we suggest further directions for theoretical and empirical research.

Re-Conceptualizing Value-Creation From Industrial Business Logic to Service Business Logic

There is an urgent interest in marketing to move away from neo-classical value definitions suggesting that value creation is a process of exchanging goods for money. In the present paper, value creation is conceptualized as an integration of two distinct, yet closely coupled processes. First, actors co-create what this paper calls an underlying basis of value. This is done by interactively re-configuring resources. By relating and combining resources, activity sets, and risks across actor boundaries in novel ways actors create joint productivity gains – a concept very similar to density (Normann, 2001). Second, actors engage in a process of signification and evaluation. Signification implies co-constructing the meaning and worth of joint productivity gains co-created through interactive resource re-configuration, as well as sharing those gains through a pricing mechanism as value to involved actors. The conceptual framework highlights an all-important dynamics associated with ´value creation´ and ´value´ - a dynamics the paper claims has eluded past marketing research. The paper argues that the framework presented here is appropriate for the interactive service perspective, where value and value creation are not objectively given, but depend on the power of involved actors´ socially constructed frames to mobilize resources across actor boundaries in ways that ´enhance system well-being´ (Vargo et al., 2008). The paper contributes to research on Service Logic, Service-Dominant Logic, and Service Science.

Value of Image in Service

Purpose This paper takes a customer view on corporate image and value, and discusses the value of image in service. We propose a model depicting how the customer’s corporate brand image affects the customer’s value-in-use. Methodology/approach The paper represents conceptual development on customers’ value and image construction processes. By integrating ideas and elements from the current service and branding literature a model is proposed that extends current views on how value-in-use emerges. Findings From a current service perspective it is the customer who makes value assessments when experiencing service. Similarly, if branding is a concept used to denote the service provider’s intentions and attempts to create a corporate brand, image construction is the corresponding process where the customer constructs the corporate image. This image construction process is always present both in service interactions and in communication and has an effect on the customer’s value-in-use. We argue that two interrelated concepts are needed to capture corporate image construction and dynamics and value-in-use – the image-in-use and image heritage. Research implications The model integrates two different streams of research pointing to the need to consider traditional marketing communication and service interactions as inherently related to each other from the customer’s point of view. Additionally the model gives a platform for understanding how value-in-use emerges over time. New methodological approaches and techniques to capture image-in-use and image heritage and their interplay with value-in-use are needed. Practical implications The company may not be able to control the emergence of value-in-use but may influence it, not only in interactions with the customer but also with pure communication. Branding activities should therefore be considered related to service operations and service development. Additionally, practitioners would need to apply qualitative methods to understand the customer’s view on image and value-in-use. Originality/value The paper presents a novel approach for understanding and studying that the customer’s image of a company influences emergence of value-in-use. The model implies that the customer’s corporate image has a crucial role for experienced value-in-use.